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      Pneumothorax after minimally invasive plate osteosynthesis for midshaft clavicle fracture : A case report

      case-report
      , MD, PhD, , MD, , MD, PhD, , MD, PhD
      Medicine
      Wolters Kluwer Health
      clavicle fracture, complication, minimally invasive plate osteosynthesis, pneumothorax

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          Abstract

          Rationale:

          Isolated fracture of clavicle is usually treated with nonoperative conservative treatment. However, surgical treatment, customized for individual patient's need, is increasingly done. With regard to the surgery of the clavicle fracture, pneumothorax is a possible, but rare complication.

          Patient concerns:

          We report the case of a 32-year-old healthy female patient who underwent minimally invasive plate osteosynthesis (MIPO) due to a clavicle fracture. To avoid direct exposure of fracture site, the pre-contoured plate was inserted through the lateral incisional port to reach the medial incisional port. There was no problem during the surgery, but the patient complained of dyspnea in the post-anesthesia care unit.

          Diagnoses:

          A chest radiograph was taken immediately, and a definitive finding of pneumothorax was revealed.

          Interventions:

          A tube was inserted at the right chest.

          Outcomes:

          The patient's dyspnea was resolved. On the 6th day after the surgery, the chest radiograph revealed that pneumothorax was nearly resolved, enabling to remove the chest tube. On the 9th day after the surgery, the patient was discharged without complication.

          Lessons:

          After clavicle surgery requiring strong dissection like MIPO, the possibility of pneumothorax is suspected and the patient should be carefully observed.

          Related collections

          Most cited references10

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          Nonoperative treatment compared with plate fixation of displaced midshaft clavicular fractures. A multicenter, randomized clinical trial

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            Rate of and Risk Factors for Reoperations After Open Reduction and Internal Fixation of Midshaft Clavicle Fractures: A Population-Based Study in Ontario, Canada.

            Reoperation rates following open reduction and internal fixation (ORIF) of midshaft clavicle fractures have been described, but reported rates of nonunion, malunion, infection, and implant removal have varied. We sought to establish baseline rates of, and risk factors for, reoperations following clavicle ORIF in a large population cohort.
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              • Article: not found

              Subcutaneous emphysema, pneumomediastinum, and potentially life-threatening tension pneumothorax. Pulmonary complications from arthroscopic shoulder decompression.

              Subcutaneous emphysema, pneumomediastinum, and tension pneumothorax are previously unreported complications of shoulder arthroscopy with subacromial decompression. Three patients developed extensive subcutaneous emphysema, pneumomediastinum, and bilateral tension pneumothorax during or immediately after shoulder arthroscopy with subacromial decompression. The procedure was terminated and appropriate treatment was given. All three patients recovered completely with no residual damage. The complications are thought to be associated with the extravasation of air that may be drawn in from the lateral portal when the arthroscopic infusion pump and power shaver with suction are turned on. Early diagnosis, followed by immediate termination of the infusion pump and suction shaver along with appropriate treatment can be life-saving.
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                Author and article information

                Journal
                Medicine (Baltimore)
                Medicine (Baltimore)
                MEDI
                Medicine
                Wolters Kluwer Health
                0025-7974
                1536-5964
                August 2019
                16 August 2019
                : 98
                : 33
                : e16836
                Affiliations
                Department of Anesthesiology and Pain Medicine, Kyung Hee University, Seoul, South Korea.
                Author notes
                []Correspondence: Hee Yong Kang, Department of Anesthesiology and Pain Medicine, Kyung Hee University Hospital, 23, Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, South Korea (e-mail: hykang531@ 123456gmail.com ).
                Article
                MD-D-18-04989 16836
                10.1097/MD.0000000000016836
                6831377
                31415405
                abe6a689-0c8b-423e-b56e-1fe25455cbef
                Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc.

                This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0

                History
                : 20 July 2018
                : 12 June 2019
                : 23 July 2019
                Categories
                7100
                Research Article
                Clinical Case Report
                Custom metadata
                TRUE

                clavicle fracture,complication,minimally invasive plate osteosynthesis,pneumothorax

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