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Brudd i kragebein

Sist revidert:
Sist revidert av:


Definisjon:
Traumatisk indusert diskontinuitet i os claviculae. 80% er lokalisert til midtre tredel av clavicula
Forekomst:
Kragebeinsbrudd forekommer hyppig, spesielt hos barn og unge, og utgjør 5-10% av alle brudd
Symptomer:
Ofte fall direkte mot skulderen eller at den skadede har tatt seg for med strak arm
Funn:
Smerte lokalt, forverres ved skulderbevegelser, ev. bloduttredelse, ev. krepitasjon i bruddspalten. Pasienten holder ofte den affiserte armen addusert og nær inntil kroppen
Diagnostikk:
Røntgen
Behandling:
Vanligvis konservativ behandling, særlig hos barn
  1. Kleinhenz BP. Clavicle fractures. Medscape, last updated Jan 14, 2019. emedicine.medscape.com  
  2. Allman FL Jr. Fractures and ligamentous injuries of the clavicle and its articulation. J Bone Joint Surg Am 1967; 49: 774-84. PubMed  
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  4. Lenza M, Buchbinder R, Johnston RV, Ferrari BAS, Faloppa F. Surgical versus conservative interventions for treating fractures of the middle third of the clavicle. Cochrane Database of Systematic Reviews 2019, Issue 1. The Cochrane Library  
  5. Woltz S, Krijnen P, Schipper IB. Plate fixation versus nonoperative treatment for displaced midshaft clavicular fractures: a meta-analysis of randomized controlled trials. J Bone Joint Surg Am. 2017 Jun 21;99(12):1051-1057 . pmid:28632595 PubMed  
  6. Zlowodzki M, Zelle BA, Cole PA, Jeray K, McKee MD. Treatment of acute midshaft clavicle fractures: systematic review of 2144 fractures: on behalf of the Evidence-Based Orthopaedic Trauma Working Group. J Orthop Trauma 2005; 19: 504-7. PubMed  
  7. Canadian Orthopaedic Trauma Society. Nonoperative treatment compared with plate fixation of displaced midshaft clavicular fractures. A multicenter, randomized clinical trial. J Bone Joint Surg Am 2007; 89: 1-10. PubMed  
  8. McKee MD, Pedersen EM, Jones C, Stephen DJ, Kreder HJ, Schemitsch EH, et al. Deficits following nonoperative treatment of displaced midshaft clavicular fractures. J Bone Joint Surg Am 2006; 88: 35-40. PubMed  
  9. Virtanen KJ, Remes V, Pajarinen J, et al. Sling compared with plate osteosynthesis for treatment of displaced midshaft clavicular fractures: a randomized clinical trial. J Bone Joint Surg Am 2012. pmid:22832887 PubMed  
  10. Xu J, Xu L, Xu W, et al. Operative versus nonoperative treatment in the management of midshaft clavicular fractures: a meta-analysis of randomized controlled trials. J Shoulder Elbow Surg 2013 Oct 12
  11. Nowak J, Holgersson M, Larsson S. Sequelae from clavicular fractures are common: a prospective study of 222 patients. Acta Orthop 2005; 76: 496-502. PubMed  
  12. McKee MD. Clavicle fractures in 2010: sling/swathe or open reduction and internal fixation? Orthop Clin North Am 2010; 41: 225-31. PubMed  
  13. Potter JM, et al. Does delay matter? The restoration of objectively measured shoulder strength and patient-oriented outcome after immediate fixation versus delayed reconstruction of displaced midshaft fractures of the clavicle. J Shoulder Elbow Surg 2007; 16: 514-8. PubMed  
  14. Hillen RJ, et al. Malunion after midshaft clavicle fractures in adults. Acta Orthop 2010; 81: 273-9. PubMed  
  15. Canadian Orthopaedic Trauma Society. Nonoperative treatment compared with plate fixation of displaced midshaft clavicular fractures. A multicenter, randomized clinical trial. J Bone Joint Surg Am 2007; 89: 1-10. PubMed  
  • Terje Johannessen, professor i allmennmedisin, Trondheim

Tidligere fagmedarbeidere

  • Arild Aamodt, overlege/professor, Ortopedisk avdeling, Lovisenberg Sykehus, Oslo
  • Søren Kold, klin. prof., overlæge, ph.d., Klinisk Institut, Aalborg Universitet og det ortopædkirurgiske speciale, Aalborg Universitetshospital