title: Locking plate external fixation and negative pressure wound therapy for treatment of a primary infection in a closed clavicle fracture.
abstract: Infection in a clavicle fracture is uncommon, but remains a challenging problem. A paucity of soft tissue coverage often combined with significant displacement and interfragmentary movement add complexity to an already difficult situation for effective infection treatment. External fixation in principle offers a means of achieving fracture stability, while the infection is being eradicated. We present the case of a closed clavicle fracture, initially treated conservatively, that presented 5 weeks later with infection. The fracture was definitively treated with external fixation using a locking plate positioned superficially to the skin, plus negative pressure wound therapy and subsequent secondary closure and antibiotic therapy. This case illustrates a novel method of treatment in this unusual presentation that was well tolerated by the patient and resulted in a good clinical outcome.
authors.affiliation: Adelaide and Meath Hospital, Dublin, Ireland.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Kenyon
authors.affiliation: Adelaide and Meath Hospital, Dublin, Ireland.
authors.forename: David I
authors.initials: DI
authors.lastname: Morrissey
authors.affiliation: Adelaide and Meath Hospital, Dublin, Ireland.
authors.forename: Diarmuid C
authors.initials: DC
authors.lastname: Molony
authors.affiliation: Department of Trauma and Orthopaedics, The Adelaide and Meath Hospital Incorporating the National Childrens Hospital, Dublin, Ireland.
authors.forename: John Francis
authors.initials: JF
authors.lastname: Quinlan
mesh_terms: D000328:Adult; D001860:Bone Plates; D002968:Clavicle / Q000293:injuries*; D005593:Fracture Fixation, Internal / Q000379:methods*; D005596:Fractures, Closed / Q000601:surgery*; D006801:Humans; D008297:Male; D054843:Negative-Pressure Wound Therapy / Q000379:methods*; D013530:Surgical Wound Infection / Q000601:surgery*; D016896:Treatment Outcome