Claviculectomía total como procedimiento de rescate. Reporte de un caso y revisión bibliográfica. [Total claviculectomy as a rescue procedure. Case report and literature review.]
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Published:
May 11, 2018
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Abstract
La pseudoartrosis de clavícula es una causa infrecuente de síndrome de opérculo torácico. En el presente artículo describimos un caso de plexopatía braquial por pseudoartrosis previamente infectada de clavícula en el cual se realizó claviculectomía total para el alivio de los síntomas. Realizamos una revisión bibliográfica del tema. Escasos artículos han sido publicados. Del análisis de la literatura citada concluimos que la claviculectomía total es una opción a ser tenida en cuenta cuando se han agotado las opciones terapéuticas. Los resultados funcionales pueden ser satisfactorios cuando la indicación es por infección, plexopatía o por sarcoma. AbstractClavicle non-union is an uncommon cause of thoracic outlet syndrome. A case of brachial plexopathy by previously infected clavicle pseudarthrosis is described. Total claviculectomy was performed for symptom relief. From literature analysis we conclude that total claviculectomy is an option to be taken into account when therapeutic options have exhausted.Functional results could be adequate when total claviculectomy is indicated in cases of infection, plexopathy or sarcoma.
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Argüelles, S., Rodriguez, M., & Pereira, E. (2018). Claviculectomía total como procedimiento de rescate. Reporte de un caso y revisión bibliográfica. [Total claviculectomy as a rescue procedure. Case report and literature review.]. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 83(2), 124-130. https://doi.org/10.15417/issn.1852-7434.2018.83.2.734
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Case Presentations
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References
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2. Neer CS II. Fractures of the clavicle. In: Rockwood CA, Green DP, eds. Fractures in Adults. Philadelphia: JB Lippincott; 1984.p707-713.
3. Rowe CR. An atlas of anatomy and treatment of mid clavicular fractures. Clin Orthop 1968: 58: 29-42.
4. Neer CS II. Nonunion of the clavicle. J Am Med Assoc. 1960. 5;(172);1006-11.
5. Hill JM, Mc Guire MH, Crosby LA. Closed treatment of displaced middle-third fractures of the clavicle gives poor results. J Bone Joint Surg Br. 1997;79(4):537-39.
6. Murray IR, Foster CJ, Eros A, Robinson CM. Risk factors for nonunion after nonoperative treatment of displaced midshaft fractures of the clavicle. J Bone Joint Surg Am. 2013;95(13):1153-8.
7. McKee RC, Whelan DB, Schemitsch EH, McKee MD. Operative versus nonoperative care of displaced midshaft clavicular fractures: a meta-analysis of randomized clinical trials. J Bone Joint Surg Am. 2012;94(8):675-84.
8. Preston CF, Egol KA. Midshaft clavicle fractures in adults. Bull NYU Hosp Jt Dis. 2009; 67(1):52-57.
9. Jeray KJ. Acute midshaft clavicular fracture. J Am Acad Orthop Surg. 2007 15(4):239-48.
10. Bravman JT, Vidal AF. Midshaft clavicle fractures: are surgical indications changing? Orthopedics. 2009; 32(12):909-913.
11. Burnham JM, Kim DC, Kamineni S. Midshaft Clavicle Fractures: A Critical Review. Orthopedics. 2016: 1;39(5):814-21.
12. VanBeek C, Boselli KJ, Cadet ER, Ahmad CS, Levine WN. Precountered plating of clavicle fractures. Decreased hardware-related complications. Clin Orthop Relat Res. 2011;469:3337–43.
13. Ranalletta M, Rossi LA, Bongiovanni SL, Tanoira I, Piuzzi NS, Maignon G. Surgical treatment of displaced midshaft clavicular fractures with precontoured plates. J Shoulder Elbow Surg. 2015;24(7):1036-40.
14. Wijdicks FJ, Van der Meijden OA, Millett PJ, Verleisdonk EJ, Houwert RM. Systematic review of the complications of plate fixation of clavicle fractures. Arch Orthop Trauma Surg. 2012;132(5):617–25.
15. Thavarajah D, Scadden J. Iatrogenic postoperative brachial plexus compression secondary to hypertrophic non-union of a clavicle fracture. Ann R Coll Surg Engl. 2013; 95(3):55–57.
16. Campbell E, Howard WP, Burklund CW. Delayed brachial plexus palsy due to ununited fracture of the clavicle; Report of a case. J Am Med Assoc. 1949;139(2):91-92.
17. Bargar WL, Marcus RE, Ittleman FP. Late thoracic outlet syndrome secondary to pseudarthrosis of the clavicle. J Trauma. 1984;24(9):857-859.
18. Connolly E, Dehne R. Nonunion of the clavicle and toracic otulet Syndrome. J Trauma. 1989;29(8):1127-32.
19. Berkheiser EJ. Old ununited clavicular fractures in the adult. Surg Gynecol Obstet. 1937;64:1064-72.
20. Marti RK, Nolte PA, Kerkhoffs GM, Besselaar PP, Schaap GR. Operative treatment of mid-shaft clavicular non unión. Int Orthop. 2003; 27:131-35.
21. Delatour HB. Excision of the Clavicle. Ann Surg. 1903;37(1):79-83.
22. Spar I. Total claviculectomy for pathological fractures. Clin Orthop Relat Res. 1977;129:236-37.
23. Gurd FB. The treatment of complete dislocation of the outer end of the clavicle: An hitertho undescribed operation. Ann Surg. 1941;113(6):1094-98.
24. Wood VE. The results of total claviculectomy. Clin Orthop Relat Res. 1986;(207):186-90.
25. Copland SM. Total resection of the clavicle. Am J Surg. 1946;72(2)280-81.
26. Abbott LC, Lucas DB. The function of the clavicle; its surgical significance. Ann Surg. 1954;140(4):583-99.
27. Oheim R, Schulz AP, Schoop R, Grimme CH, Gille J, Gerlach UJ. Medium-term results after total claviculectomy in cases of osteitis: a consecutive case series of five patients. Int Orthop. 2012;36:775-78.
28. Wessel RN, Schaap GR. Outcome of total claviculectomy in six cases. J Shoulder Elbow Surg. 2007;16(3):312-315.
29. Kay SP, Eckardt JJ. Brachial plexus palsy secondary to clavicular non unión. Case report and literature survey. Clin Orthop Relat Res. 1986;(206):219-22.
30. Waissmann M, Saad E, Waissmann A. Cleidectomia Total. Rev Asoc Arg Ortop Traumatol. 1990; 55(2):233-245.
31. Codman EA: The shoulder: Rupture of the supraespinatus tendon and another lesions in of about the sub acromial bursa. Boston: Thomas Todd, 1934.
32. Ring D, Jupiter JB. Ununited Fractures of the Clavicle with Bony Defect: Treatment with Corticocancellous Interposition Bone Graft and Plate Fixation. Tech hand Up Extrem Surg. 1999;3(3):193-196.
33. Kirshnan KG, Mucha D, Gupta R, Schackert G. Brachial plexus compression caused by recurrent clavicular nonunion and space-occupying pseudoarthrosis: definitive reconstruction using free vascularized bone flap-a series of eight cases. Neurosurgery. 2008;62(2):461-9.
34. Rubright J, Kelleher P, Beardsley C, Paller D, Shackford S, Beynnon B, et al. Long term clinical outcomes, motion, strength, and function after total claviculectomy. J Shoulder Elbow Surg. 2014;23(2)236-44.
35. Camargo PR, Phadke V, Braman JP, Ludewig PM. Three-dimensional shoulder kinematics after total claviculectomy: a biomechanical investigation of a single case. Man Ther. 2013;18(6):620-23.
36. Baratz M, Appleby D, Fu FH. Life threatening clavicular osteomyelitis in two debilitated patients. Orthopedics. 1985;8(12):1492-94.
37. Lord JW, Wright IS.Total claviculectomy for neurovascular compression in the thoracic outlet.Surg Gynecol Obstet. 1993;176(6):609-612.
38. Gaulke R, Schmitz HG. Considerations of biomechanics after clavicular resection. Case report of rower with Ewing sarcoma. Unfallchirurg. 1998;101(2):153-37.
39. Krishnan SG, Shiffern SC, Pennington SD, Rimlawi M, Burkhead WZ Jr. Functional outcomes after total claviculectomy as a salvage procedure. A series of six cases. J Bone Surg Am. 2007;89(6)1215-19.
40. Kapoor S, Tiwari A, Kapoor S. Primary tumours and tumorous lesions of the clavicle. Int Orthop. 2008;32:829-34.
41. Argintar E, Holzman M, Gunther S. Bipolar clavicular dislocation. Orthopedics. 2011; 7;34(7):316-9.
42. Ye Z, Zhang M, Functional and oncological outcomes after total
claviculectomy for primary malignancy. Acta Orthop Belg. 2012; 78(2);170-74.
2. Neer CS II. Fractures of the clavicle. In: Rockwood CA, Green DP, eds. Fractures in Adults. Philadelphia: JB Lippincott; 1984.p707-713.
3. Rowe CR. An atlas of anatomy and treatment of mid clavicular fractures. Clin Orthop 1968: 58: 29-42.
4. Neer CS II. Nonunion of the clavicle. J Am Med Assoc. 1960. 5;(172);1006-11.
5. Hill JM, Mc Guire MH, Crosby LA. Closed treatment of displaced middle-third fractures of the clavicle gives poor results. J Bone Joint Surg Br. 1997;79(4):537-39.
6. Murray IR, Foster CJ, Eros A, Robinson CM. Risk factors for nonunion after nonoperative treatment of displaced midshaft fractures of the clavicle. J Bone Joint Surg Am. 2013;95(13):1153-8.
7. McKee RC, Whelan DB, Schemitsch EH, McKee MD. Operative versus nonoperative care of displaced midshaft clavicular fractures: a meta-analysis of randomized clinical trials. J Bone Joint Surg Am. 2012;94(8):675-84.
8. Preston CF, Egol KA. Midshaft clavicle fractures in adults. Bull NYU Hosp Jt Dis. 2009; 67(1):52-57.
9. Jeray KJ. Acute midshaft clavicular fracture. J Am Acad Orthop Surg. 2007 15(4):239-48.
10. Bravman JT, Vidal AF. Midshaft clavicle fractures: are surgical indications changing? Orthopedics. 2009; 32(12):909-913.
11. Burnham JM, Kim DC, Kamineni S. Midshaft Clavicle Fractures: A Critical Review. Orthopedics. 2016: 1;39(5):814-21.
12. VanBeek C, Boselli KJ, Cadet ER, Ahmad CS, Levine WN. Precountered plating of clavicle fractures. Decreased hardware-related complications. Clin Orthop Relat Res. 2011;469:3337–43.
13. Ranalletta M, Rossi LA, Bongiovanni SL, Tanoira I, Piuzzi NS, Maignon G. Surgical treatment of displaced midshaft clavicular fractures with precontoured plates. J Shoulder Elbow Surg. 2015;24(7):1036-40.
14. Wijdicks FJ, Van der Meijden OA, Millett PJ, Verleisdonk EJ, Houwert RM. Systematic review of the complications of plate fixation of clavicle fractures. Arch Orthop Trauma Surg. 2012;132(5):617–25.
15. Thavarajah D, Scadden J. Iatrogenic postoperative brachial plexus compression secondary to hypertrophic non-union of a clavicle fracture. Ann R Coll Surg Engl. 2013; 95(3):55–57.
16. Campbell E, Howard WP, Burklund CW. Delayed brachial plexus palsy due to ununited fracture of the clavicle; Report of a case. J Am Med Assoc. 1949;139(2):91-92.
17. Bargar WL, Marcus RE, Ittleman FP. Late thoracic outlet syndrome secondary to pseudarthrosis of the clavicle. J Trauma. 1984;24(9):857-859.
18. Connolly E, Dehne R. Nonunion of the clavicle and toracic otulet Syndrome. J Trauma. 1989;29(8):1127-32.
19. Berkheiser EJ. Old ununited clavicular fractures in the adult. Surg Gynecol Obstet. 1937;64:1064-72.
20. Marti RK, Nolte PA, Kerkhoffs GM, Besselaar PP, Schaap GR. Operative treatment of mid-shaft clavicular non unión. Int Orthop. 2003; 27:131-35.
21. Delatour HB. Excision of the Clavicle. Ann Surg. 1903;37(1):79-83.
22. Spar I. Total claviculectomy for pathological fractures. Clin Orthop Relat Res. 1977;129:236-37.
23. Gurd FB. The treatment of complete dislocation of the outer end of the clavicle: An hitertho undescribed operation. Ann Surg. 1941;113(6):1094-98.
24. Wood VE. The results of total claviculectomy. Clin Orthop Relat Res. 1986;(207):186-90.
25. Copland SM. Total resection of the clavicle. Am J Surg. 1946;72(2)280-81.
26. Abbott LC, Lucas DB. The function of the clavicle; its surgical significance. Ann Surg. 1954;140(4):583-99.
27. Oheim R, Schulz AP, Schoop R, Grimme CH, Gille J, Gerlach UJ. Medium-term results after total claviculectomy in cases of osteitis: a consecutive case series of five patients. Int Orthop. 2012;36:775-78.
28. Wessel RN, Schaap GR. Outcome of total claviculectomy in six cases. J Shoulder Elbow Surg. 2007;16(3):312-315.
29. Kay SP, Eckardt JJ. Brachial plexus palsy secondary to clavicular non unión. Case report and literature survey. Clin Orthop Relat Res. 1986;(206):219-22.
30. Waissmann M, Saad E, Waissmann A. Cleidectomia Total. Rev Asoc Arg Ortop Traumatol. 1990; 55(2):233-245.
31. Codman EA: The shoulder: Rupture of the supraespinatus tendon and another lesions in of about the sub acromial bursa. Boston: Thomas Todd, 1934.
32. Ring D, Jupiter JB. Ununited Fractures of the Clavicle with Bony Defect: Treatment with Corticocancellous Interposition Bone Graft and Plate Fixation. Tech hand Up Extrem Surg. 1999;3(3):193-196.
33. Kirshnan KG, Mucha D, Gupta R, Schackert G. Brachial plexus compression caused by recurrent clavicular nonunion and space-occupying pseudoarthrosis: definitive reconstruction using free vascularized bone flap-a series of eight cases. Neurosurgery. 2008;62(2):461-9.
34. Rubright J, Kelleher P, Beardsley C, Paller D, Shackford S, Beynnon B, et al. Long term clinical outcomes, motion, strength, and function after total claviculectomy. J Shoulder Elbow Surg. 2014;23(2)236-44.
35. Camargo PR, Phadke V, Braman JP, Ludewig PM. Three-dimensional shoulder kinematics after total claviculectomy: a biomechanical investigation of a single case. Man Ther. 2013;18(6):620-23.
36. Baratz M, Appleby D, Fu FH. Life threatening clavicular osteomyelitis in two debilitated patients. Orthopedics. 1985;8(12):1492-94.
37. Lord JW, Wright IS.Total claviculectomy for neurovascular compression in the thoracic outlet.Surg Gynecol Obstet. 1993;176(6):609-612.
38. Gaulke R, Schmitz HG. Considerations of biomechanics after clavicular resection. Case report of rower with Ewing sarcoma. Unfallchirurg. 1998;101(2):153-37.
39. Krishnan SG, Shiffern SC, Pennington SD, Rimlawi M, Burkhead WZ Jr. Functional outcomes after total claviculectomy as a salvage procedure. A series of six cases. J Bone Surg Am. 2007;89(6)1215-19.
40. Kapoor S, Tiwari A, Kapoor S. Primary tumours and tumorous lesions of the clavicle. Int Orthop. 2008;32:829-34.
41. Argintar E, Holzman M, Gunther S. Bipolar clavicular dislocation. Orthopedics. 2011; 7;34(7):316-9.
42. Ye Z, Zhang M, Functional and oncological outcomes after total
claviculectomy for primary malignancy. Acta Orthop Belg. 2012; 78(2);170-74.