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The aetiology and epidemiology of clavicular fractures. A prospective study during a two-year period in Uppsala, Sweden.

https://arctichealth.org/en/permalink/ahliterature52492
Source
Injury. 2000 Jun;31(5):353-8
Publication Type
Article
Date
Jun-2000
Author
J. Nowak
H. Mallmin
S. Larsson
Author Affiliation
Department of Orthopaedics, Uppsala University Hospital, SE-751 85, Uppsala, Sweden. jan.nowak@ortopedi.uu.se
Source
Injury. 2000 Jun;31(5):353-8
Date
Jun-2000
Language
English
Publication Type
Article
Keywords
Accidents, Traffic
Adolescent
Adult
Age Distribution
Aged
Aged, 80 and over
Clavicle - injuries
Female
Fractures, Bone - epidemiology - etiology
Humans
Incidence
Male
Middle Aged
Prospective Studies
Seasons
Sex Distribution
Sweden - epidemiology
Abstract
In a prospective study, the age- and gender-specific incidence and features of clavicular fractures were studied during 1989 and 1990. The population at risk consisted of about 200,000 individuals aged 15 or above in the county of Uppsala, Sweden. There were 187 clavicular fractures in 185 patients corresponding to an annual incidence of 50/100,000 (males 71/100,000, women 30/100,000). Males were significantly younger and sustained comminuted fractures more often than women. The fracture incidence decreased with age in both genders, although the reduction was significant only in men. Bicycle accidents most frequently caused clavicular fractures in both genders, whereas sports activities were significantly more common in men. Right and left clavicles were almost as frequently fractured, and a direct fall on the shoulder was the most frequent mechanism of injury for both genders. There was no difference between genders in the anatomical location with about three of four fractures occurring through the middle part and one of four through the acromial part of the clavicle. Ninety-five percent healed uneventfully, while non-union developed in 5% - evenly distributed between the middle part of the clavicle and the acromial part.
PubMed ID
10775691 View in PubMed
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Birth injuries: incidence and predisposing factors.

https://arctichealth.org/en/permalink/ahliterature228918
Source
Z Kinderchir. 1990 Jun;45(3):133-5
Publication Type
Article
Date
Jun-1990
Author
I S Salonen
R. Uusitalo
Author Affiliation
Department of Obstetrics and Surgery, Satakunta Central Hospital, Pori, Finland.
Source
Z Kinderchir. 1990 Jun;45(3):133-5
Date
Jun-1990
Language
English
Publication Type
Article
Keywords
Birth Injuries - epidemiology
Birth weight
Brachial Plexus - injuries
Clavicle - injuries
Fetal Macrosomia - epidemiology
Finland - epidemiology
Fractures, Bone - epidemiology
Humans
Incidence
Infant, Newborn
Abstract
The incidence of birth-associated major injuries among 14.265 live born infants during seven years is presented. The occurrence of major trauma was 3.16% or 441 injuries in 437 children. The most usual injury was fracture of the clavicle, which occurred in 3.0%, after that brachial plexus injury with occurrence of 0.11%, and fracture of long bones with 0.03%. In addition to that there was one child with facial nerve palsy. Four children had two birth injuries each. The most important causes of brachial plexus injury were macrosomia and shoulder dystocia. Eight of 16 children with brachial plexus injury had shoulder dystocia and six of 16 macrosomia. The frequency of macrosomia in our material of 14.265 children was 4.7%, which is much higher than earlier reports by other authors.
PubMed ID
2375180 View in PubMed
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Clavicle fractures: epidemiology, classification and treatment of 2 422 fractures in the Swedish Fracture Register; an observational study.

https://arctichealth.org/en/permalink/ahliterature286116
Source
BMC Musculoskelet Disord. 2017 Feb 15;18(1):82
Publication Type
Article
Date
Feb-15-2017
Author
Caroline Kihlström
Michael Möller
Katarina Lönn
Olof Wolf
Source
BMC Musculoskelet Disord. 2017 Feb 15;18(1):82
Date
Feb-15-2017
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Bone Plates
Clavicle - injuries
Female
Fracture Fixation, Internal - instrumentation - statistics & numerical data
Fractures, Bone - classification - epidemiology - surgery
Humans
Male
Middle Aged
Multiple Trauma - epidemiology
Registries
Sex Factors
Sweden - epidemiology
Young Adult
Abstract
Large multi-centre studies of clavicle fractures have so far been missing. The aim of this observational study was to describe the epidemiology, classification and treatment of clavicle fractures in the The Swedish Fracture Register (SFR) that collects national prospective data from large fracture populations.
Data were retrieved from the SFR on all clavicle fractures sustained by patients?=?15 years of age in 2013-2014 (n?=?2 422) with regards to date of injury, cause of injury, fracture classification and treatment.
Sixty-eight per cent of the clavicle fractures occurred in males. The largest subgroup was males aged 15-24 years, representing 21% of clavicle fractures. At the ages of 65 years and above, females sustained more clavicle fractures than males. Same-level falls and bicycle accidents were the most common injury mechanisms. Displaced midshaft fractures constituted 43% of all fractures and were the most frequently operated fractures. Seventeen per cent of the patients underwent operative treatment within 30 days of the injury, where plate fixation was the choice of treatment in 94% of fractures.
The largest patient group was young males. Displaced midshaft fractures were the most common type of clavicle fracture as well as the most frequently operated type of fracture.
Notes
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Cites: Injury. 2000 Jun;31(5):353-810775691
Cites: J Bone Joint Surg Br. 1998 May;80(3):476-849619941
Cites: BMC Musculoskelet Disord. 2015 Nov 06;16:33826546157
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Cites: J Bone Joint Surg Am. 2008 Mar;90 Suppl 2 Pt 1:1-818310682
PubMed ID
28202071 View in PubMed
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The effects of local anesthetic concentration and dose on continuous infraclavicular nerve blocks: a multicenter, randomized, observer-masked, controlled study.

https://arctichealth.org/en/permalink/ahliterature153581
Source
Anesth Analg. 2009 Jan;108(1):345-50
Publication Type
Article
Date
Jan-2009
Author
Brian M Ilfeld
Linda T Le
Joanne Ramjohn
Vanessa J Loland
Anupama N Wadhwa
J C Gerancher
Elizabeth M Renehan
Daniel I Sessler
Jonathan J Shuster
Douglas W Theriaque
Rosalita C Maldonado
Edward R Mariano
Author Affiliation
Department of Anesthesiology, University of California San Diego, San Diego, California 92037-7651, USA. bilfeld@ucsd.ed
Source
Anesth Analg. 2009 Jan;108(1):345-50
Date
Jan-2009
Language
English
Publication Type
Article
Keywords
Adult
Amides - administration & dosage - adverse effects
Anesthetics, Local - administration & dosage - adverse effects
Brachial Plexus - drug effects
Clavicle - innervation
Dose-Response Relationship, Drug
Drug Administration Schedule
Female
Humans
Infusion Pumps
Infusions, Parenteral
Male
Middle Aged
Nerve Block - methods
Ontario
Orthopedic Procedures - adverse effects
Pain Measurement
Pain Threshold - drug effects
Pain, Postoperative - etiology - prevention & control
Patient satisfaction
Single-Blind Method
Touch - drug effects
United States
Abstract
It remains unclear whether local anesthetic concentration or total drug dose is the primary determinant of continuous peripheral nerve block effects. The only previous investigation, involving continuous popliteal-sciatic nerve blocks, specifically addressing this issue reported that insensate limbs were far more common with higher volumes of relatively dilute ropivacaine compared with lower volumes of relatively concentrated ropivacaine. However, it remains unknown if this relationship is specific to the sciatic nerve in the popliteal fossa or whether it varies depending on anatomic location. We therefore tested the null hypothesis that providing ropivacaine at different concentrations and rates, but at an equal total basal dose, produces comparable effects when used in a continuous infraclavicular brachial plexus block.
Preoperatively, an infraclavicular catheter was inserted using the coracoid approach in patients undergoing moderately painful orthopedic surgery distal to the elbow. Patients were randomly assigned to receive a postoperative perineural ropivacaine infusion of either 0.2% (basal 8 mL/h, bolus 4 mL) or 0.4% (basal 4 mL/h, bolus 2 mL) through the second postoperative day. Both groups, therefore, received 16 mg of ropivacaine each hour with a possible addition of 8 mg every 30 min via a patient-controlled bolus dose. Our primary end point was the incidence of an insensate limb during the 24-h period beginning the morning after surgery. Secondary end points included analgesia and patient satisfaction.
Patients given 0.4% ropivacaine (n = 27) experienced an insensate limb, a mean (sd) of 1.8 (1.6) times, compared with 0.6 (0.9) times for subjects receiving 0.2% ropivacaine (n = 23; estimated difference = 1.2 episodes, 95% confidence interval, 0.5-1.9 episodes; P = 0.001). Satisfaction with postoperative analgesia (scale 0-10, 10 = highest) was scored a median (25th-75th percentiles) of 10.0 (8.0-10.0) in Group 0.2% and 7.0 (5.3-8.9) in Group 0.4% (P = 0.018). Analgesia was similar in each group.
For continuous infraclavicular nerve blocks, local anesthetic concentration and volume influence perineural infusion effects in addition to the total mass of local anesthetic administered. Insensate limbs were far more common with smaller volumes of relatively concentrated ropivacaine. This is the opposite of the relationship previously reported for continuous popliteal-sciatic nerve blocks. The interaction between local anesthetic concentration and volume is thus complex and varies among catheter locations.
Notes
Cites: Anesth Analg. 2008 Aug;107(2):701-718633055
Cites: J Clin Anesth. 2000 Dec;12(8):595-911172999
Cites: Reg Anesth Pain Med. 2007 May-Jun;32(3):183-517543811
Cites: Anesthesiology. 2001 Nov;95(5):1051-311684970
Cites: Minerva Anestesiol. 2001 Sep;67(9 Suppl 1):117-2011778105
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Cites: Pain. 2003 Sep;105(1-2):151-714499431
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Cites: Reg Anesth Pain Med. 2004 Jan-Feb;29(1):9-1614727272
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Comment In: Anesth Analg. 2009 Oct;109(4):1347-8; author reply 1348-919762771
PubMed ID
19095871 View in PubMed
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Fractures on chest radiographs in detection of alcoholism.

https://arctichealth.org/en/permalink/ahliterature233724
Source
Alcohol Alcohol. 1988;23(1):53-6
Publication Type
Article
Date
1988
Author
L. Keso
A. Kivisaari
M. Salaspuro
Author Affiliation
Department of Radiology, Helsinki University Central Hospital, Finland.
Source
Alcohol Alcohol. 1988;23(1):53-6
Date
1988
Language
English
Publication Type
Article
Keywords
Adult
Alcoholism - complications - diagnosis
Clavicle - injuries
Finland
Fractures, Bone - epidemiology - etiology
Humans
Male
Marriage
Middle Aged
Radiography, Thoracic
Rib Fractures - epidemiology - etiology
Social Class
Thoracic Vertebrae - injuries
Abstract
The prevalence of fractures seen on chest radiographs among alcoholics varies in various series from 36.0% to 8.7% while that for controls remains below 5%. The aim of our study was to find out whether the selection of the alcoholic subjects could account for this four-fold variation. We therefore chose two groups of alcoholics, group 1 consisting of 76 mainly unmarried or divorced lower class alcoholics who had attended the emergency department while intoxicated, and group 2 consisting of 108 mainly married middle class alcoholics with alcoholic liver cirrhosis. The control group consisted of 98 randomly chosen hospital patients. There was no significant difference between group 1 and group 2 in the prevalence of fractures detectable with chest radiography (25% and 21.3% respectively). 8.2% of the controls also had fractures. The fracture prevalence did not correlate with socioeconomic group. Married alcoholics had significantly less thoracic fractures than unmarried, divorced or widowed alcoholics as a group. The sensitivity and specificity of the fractures visible on chest radiograph as a marker for alcoholism is not sufficient to warrant its use in clinical or research work.
PubMed ID
3358824 View in PubMed
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Hook-plate fixation of unstable lateral clavicle fractures: a report on 63 patients.

https://arctichealth.org/en/permalink/ahliterature167755
Source
Acta Orthop. 2006 Aug;77(4):644-9
Publication Type
Article
Date
Aug-2006
Author
Tapio Flinkkilä
Jukka Ristiniemi
Martti Lakovaara
Pekka Hyvönen
Juhana Leppilahti
Author Affiliation
Department of Surgery, Division of Orthopaedic and Trauma Surgery, University Hospital. Oulu, FI-90029 OYS. Finland. Tapio.Flinkkila@ppshp.fi
Source
Acta Orthop. 2006 Aug;77(4):644-9
Date
Aug-2006
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Bone Plates
Clavicle - injuries - radiography - surgery
Female
Fracture Fixation, Internal - adverse effects - instrumentation - methods
Fracture Healing
Fractures, Bone - radiography - surgery
Humans
Male
Middle Aged
Questionnaires
Treatment Outcome
Abstract
Hook-plate fixation of unstable lateral clavicle fractures has given promising results in previous reports, but numbers of patients have been small. We assessed the results of this technique in 63 patients.
63 patients with unstable lateral clavicle fractures were operated on at Oulu University Hospital during 1997-2004, using a clavicle hook-plate. Fracture union and complications were assessed retrospectively from case records and radiographs. The subjective part of the Constant score, Oxford shoulder questionnaire data and subjective shoulder value (SSV) were assessed after an average of 3.6 years in 58 patients. 31 patients were reviewed at the outpatient clinic, using complete Constant scores and radiographs of both acromioclavicular joints.
59 fractures united uneventfully. There was 1 case of delayed union and 3 nonunions, but only 1 of these required surgery. Additional complications involved 1 case of infection, 1 frozen shoulder and 3 cases of late fracture medial to the plate. The mean Oxford score was 15, the mean for the subjective part of the Constant score was 32, and the SSV was 86%.
Clavicle hook-plate fixation of unstable lateral clavicle fractures results in a good union rate and good shoulder function.
PubMed ID
16929443 View in PubMed
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Incidence and causes of shoulder girdle injuries in an urban population.

https://arctichealth.org/en/permalink/ahliterature35391
Source
J Shoulder Elbow Surg. 1995 Mar-Apr;4(2):107-12
Publication Type
Article
Author
A. Nordqvist
C J Petersson
Author Affiliation
Department of Orthopaedics, Malmö General Hospital, Lund University, Sweden.
Source
J Shoulder Elbow Surg. 1995 Mar-Apr;4(2):107-12
Language
English
Publication Type
Article
Keywords
Acromioclavicular Joint - injuries
Adolescent
Adult
Aged
Clavicle - injuries
Female
Humans
Male
Middle Aged
Research Support, Non-U.S. Gov't
Scapula - injuries
Shoulder Dislocation - epidemiology
Shoulder Fractures - epidemiology
Sweden - epidemiology
Urban Population
Abstract
In a prospective population-based study of all shoulder injuries seen at Malmö General Hospital during 1987, the incidence and causes of major injuries involving fractures of the clavicle, scapula, or proximal humerus and glenohumeral or acromioclavicular dislocations were investigated in children, adults, and the elderly. Seventy-five shoulder injuries occurred in children. Sixty-five of them were fractures of the clavicle. In this age group no sex-related differences were seen in incidence, and 37 of 73 injuries were related to sports or playing. One hundred eighty-one injuries occurred in adults. Sixty fractures of the proximal humerus, 67 fractures of the clavicle, and 31 primary glenohumeral dislocations were seen. The injuries in this group were significantly more frequent in men, with most of them caused by traffic and sport injuries. Two hundred forty-eight injuries occurred in elderly people. Two hundred one were fractures of the proximal humerus. The incidence was significantly higher in women; 147 of 247 injuries were caused by an indoor fall. The variations among age groups are probably attributable to age-related differences in activity, mobility, and fragility.
PubMed ID
7600160 View in PubMed
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The incidence of fractures of the clavicle.

https://arctichealth.org/en/permalink/ahliterature35876
Source
Clin Orthop Relat Res. 1994 Mar;(300):127-32
Publication Type
Article
Date
Mar-1994
Author
A. Nordqvist
C. Petersson
Author Affiliation
Department of Orthopaedics, Malmö General Hospital, Lund University, Sweden.
Source
Clin Orthop Relat Res. 1994 Mar;(300):127-32
Date
Mar-1994
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Clavicle - injuries
Female
Fractures, Bone - classification - epidemiology - etiology
Humans
Incidence
Infant
Male
Middle Aged
Research Support, Non-U.S. Gov't
Sweden - epidemiology
Abstract
The age- and gender-specific incidences were calculated in 2035 cases of fracture of the clavicle. The fractures were classified in three groups according to the Allman system. Each group was further divided into undisplaced and displaced fracture subgroups, with an extra subgroup of comminuted midclavicular fractures in Group I. Seventy-six percent of the fractures were classified as Allman Group I. The median age in this group was 13 years. There were significant differences in age- and gender-specific incidence between the undisplaced, displaced, and comminuted fracture subgroups. Twenty-one percent were classified as Allman Group II. The median age of the patients was 47 years, and there was no difference in age between the undisplaced and displaced fracture subgroups. Three percent were classified as Allman Group III, and the median age of the patients in this group was 59 years. All three groups were characterized by a significant preponderance of men, and there was a significant increase in the incidence of clavicular fracture, both overall and sports-related, between 1952 and 1987.
PubMed ID
8131324 View in PubMed
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The incidence of malignant primary bone tumours in relation to age, sex and site. A study of osteogenic sarcoma, chondrosarcoma and Ewing's sarcoma diagnosed in Sweden from 1958 to 1968.

https://arctichealth.org/en/permalink/ahliterature28083
Source
J Bone Joint Surg Br. 1974 Aug;56B(3):534-40
Publication Type
Article
Date
Aug-1974

[Increased birth weights in the Nordic countries. A growing proportion of neonates weigh more than four kilos]

https://arctichealth.org/en/permalink/ahliterature21330
Source
Lakartidningen. 1998 Nov 25;95(48):5488-92
Publication Type
Article
Date
Nov-25-1998
Author
G. Meeuwisse
P O Olausson
Source
Lakartidningen. 1998 Nov 25;95(48):5488-92
Date
Nov-25-1998
Language
Swedish
Publication Type
Article
Keywords
Birth weight
Brachial Plexus - injuries
Cephalometry
Cesarean Section - statistics & numerical data
Clavicle - injuries
English Abstract
Female
Fractures, Bone - epidemiology - etiology
Humans
Infant, Newborn
Obstetric Labor Complications - epidemiology - etiology
Pregnancy
Risk factors
Scandinavia - epidemiology
Sweden - epidemiology
Vacuum Extraction, Obstetrical - statistics & numerical data
Abstract
The proportion of children with high birthweights is increasing in Sweden, as in the other Nordic countries. According to the Swedish national birth registry (founded in 1973), the proportion of term (i.e. (37 gestational weeks) offspring of singelton pregnancies, and weighing four kg or more, increased from 16.9 per cent in 1973 to 20.3 per cent in 1995. The respective figures for the first-born subgroup were 12.9 and 15 per cent, the increase in mean birthweight being from 3400 to 3520 g. There was a corresponding increase in head circumference. The risk of delivery-related complications increases with birthweight over four kg, and a higher incidence of major perineal rupture (grade 3 or 4) has been reported, as well as a disturbing increase in the incidence of brachial plexus damage. Findings in recent studies suggest high birthweight to be associated with an increased risk of subsequent morbidity, both in childhood and in adulthood, specifically diabetes type 1, eczema and certain malignancies, particularly breast cancer and prostate cancer. Although the cause of the increasing proportion of large newborns is not known, it may be partly due to weight increase among gravidae. Another possible explanation is reduced maternal smoking, as smoking is less common now than in the 1970s.
PubMed ID
9854374 View in PubMed
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22 records – page 1 of 3.