Background Clavicle fractures account for approximately 5% of all fractures in adults and 75% of clavicle fractures occur in the midshaft. Shortening greater than two centimeters is an indicative of surgical treatment. Radiographic exams are often used to diagnose and evaluate clavicle fractures but computed tomography (CT) scan is currently considered the best method to assess these deformities and shortening. Goal 1- To investigate whether different methods of performing the radiographic exam interfere on the measurement of the fractured clavicle length. 2- Compare the clavicle length measurements obtained by the different radiographic exam methods with the CT scan measurements, used as a reference. Materials and methods Twenty-five patients with acute (< 3 weeks) midshaft clavicle fracture were evaluated. Patients underwent six radiographic images: PA Thorax (standing and lying), AP Thorax (standing and lying) and at 10° cephalic tilt (standing and lying), and the computed tomography was used as reference. Results The mean length (cm) obtained were: 14,930 on CT scan, 14,860 on PA Thorax Standing, 14,955 on PA Thorax Lying, 14,896 on AP Thorax Standing, 14,960 AP Thorax Lying, 15,098 on 10° cephalic tilt Standing and 15,001 on 10° cephalic tilt Lying, (p > 0,05). Conclusion 1- There is no significant statistical difference in the clavicle fracture length measurement among the variety of radiographic exam performances. 2- The method that comes closest to computed tomography results is the PA thorax incidence, with the patient in the lying position.

Objective. To evaluate the effectiveness of two antifibrinolytic drugs (tranexamic acid and epsilon-aminocaproic acid) in reducing postoperative hemarthrosis after anterior cruciate ligament reconstruction. Methods. 45 patients diagnosed with primary anterior cruciate ligament tears were randomly placed into 3 groups: control, tranexamic acid (TXA) and epsilon-aminocaproic acid (EAC). The first group was operated on without the use of the drugs, and for the other two, the dose was adjusted by weight. The evaluation was conducted for 1 and 7 postoperative days to assess the degree of hemarthrosis, assess the visual pain scale and measure the range of motion (ROM) in degrees. The patients were then assigned a subjective functional score at 14 and 28 postoperative days. Results. The TXA group showed improvement on the postoperative pain scale after 7 days compared to the control group. When evaluated with the Lysholm functional score, the TXA group showed improvement compared to the control group. No significant statistical difference emerged in the parameter evaluated for the EAC group. Conclusions. The tranexamic-acid group showed reduced pain and improved function after arthroscopic reconstruction of the ACL. Up to this point, the use of Epsilon-aminocaproic acid yielded no benefit. A follow-up study with more participants may confirmation our findings or present new relevant findings.

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Introduction and importance Surgical treatment for clavicle injuries is indicated for displaced and shortened fractures. Osteosyntheses with plate fixation may present with complications in 6.3% to 8.5% of patients. Peri-implant clavicle fractures (PIF) are rare, and we have not found any previous cases in our literature search. Case presentation A 25-year-old male with previously (six years earlier) surgically treated clavicle fracture presented with a peri-implant clavicle fracture requiring surgical treatment. The management involved overlaying an implant to fix the lateral clavicle fracture without removing the previous plate. Complete bone healing was observed without any further complication. Clinical discussion Despite the low rate of implant failure in clavicle fractures, this complication occurs mainly in elderly patients with poor bone quality. No PIF have been described in the literature prior to this. This case report demonstrates a young patient with good bone quality and previous fracture fixation presenting with PIF which has now shown complete bone healing. Conclusion In this case, overlying an additional plate on the lateral clavicle portion without removing the previous plate increased the stability of the fracture. It demonstrates the value of overlaying plate osteosyntheses for patients with clavicle PIF.

Background. Clavicle fractures account for approximately 5% of all fractures in adults and 75% of clavicle fractures occur in the midshaft. Shortening greater than two centimeters is an indicative of surgical treatment. Radiographic exams are often used to diagnose and evaluate clavicle fractures but computed tomography (CT) scan is currently considered the best method to assess these deformities and shortening. Goal. 1- To investigate whether different methods of performing the radiographic exam interfere with the measurement of the fractured clavicle length. Goal 2- Compare the clavicle length measurements obtained by the different radiographic exam methods with the CT scan measurements, used as a reference.Materials and Methods. Twenty-five patients with acute (< 3weeks) midshaft clavicle fracture were evaluated. Patients underwent six radiographic images: PA Thorax (standing and lying), AP Thorax (standing and lying) and at 10º cephalic tilt (standing and lying), and the computed tomography was used as reference.Results. There wasn't any significant statistical difference in the clavicle fracture length measurement among the variety of radiographic exam performances when compared to tomography.Conclusion. 1- There is no significant statistical difference in the clavicle fracture length measurement among the variety of radiographic exam performances. Conclusion. 2- The method that comes closest to computed tomography results is the PA thorax incidence, with the patient in the lying position.