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Orthopedic Services
Glendale Adventist Medical Center
1509 Wilson Terrace
Glendale, CA 91206
Ph: (818) 409-8000

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Have you ever heard of intramedullary fixation for a broken collar bone? That's what my kid has from a snowboarding accident. In my day, they would have slapped a sling on that baby and called it good. Is all this monkey business really needed (to the tune of 1000s of dollars for the surgery)?

You are right -- years ago, patients with a collar bone fracture (no matter how severe) would have been put in a sling. The body had to heal itself as best as possible. But deformity and loss of function were often the result with this type of conservative care. Now, the use of a flexible intramedullary (IM) device has changed all that. Even collar bones that are broken into many pieces can be threaded back together with this implant. It is threaded through the bones following a guide wire that marks the path. Then it is locked in place to provide rigid support. Studies show that the results are much improved over nonoperative care with a sling. And the cost is justified by the fact that the patient regains full motion with a normal anatomic appearance. Given how important the collar bone is to all motions of the upper extremity, it's hard to put a price tag on this procedure. The surgeon must be careful to avoid hitting nerves and blood vessels in the area. At the same time, he or she must find all of the fragmented pieces of bone to include in the reduction. The surgeon will use a special radiographic device called a fluoroscope to accomplish these tasks. Fluroscopy allows the surgeon to see inside in real-time (four dimensions). One last fluoroscopic exam is done to make sure everything is in place properly. If not, the surgeon pulls the implant out and starts over or makes whatever adjustments are needed to get a good reduction. The added cost of this imaging device is well-worth it in order to avoid complications and problems. The use of this special device (the intramedullary (IM) implant) is safe and effective. The approach spares the soft tissues of damage, prevents deformities, and even avoids unsightly incision lines and scars. As the younger generation is fond of saying, "What's not to like?"


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