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Mini-T Plate Fixation for Neer Type II Distal Clavicle Fracture

Neer 분류 제 2형 원위부 쇄골 골절의 mini-T형 금속판 고정

  • Yum, Jae-Kwang (Department of Orthopedic Surgery, Sanggye Paik Hospital, School of Medicine, Inje Univ.) ;
  • Lee, Sang-Lim (Department of Orthopedic Surgery, Sanggye Paik Hospital, School of Medicine, Inje Univ.) ;
  • Ra, Ho-Jong (Department of Orthopedic Surgery, Sanggye Paik Hospital, School of Medicine, Inje Univ.)
  • 염재광 (인제대학교 의과대학 상계백병원 정형외과학교실) ;
  • 이상림 (인제대학교 의과대학 상계백병원 정형외과학교실) ;
  • 라호종 (인제대학교 의과대학 상계백병원 정형외과학교실)
  • Published : 2009.06.15

Abstract

Purpose: To evaluate and report the clinical and radiological outcomes of open reduction and internal fixation with a mini-T plate for unstable distal clavicle fractures. Materials and Methods: From December 2004 to July 2007, fifteen patients who had a fracture of the distal clavicle (Neer type II fracture) were treated with an open reduction and internal fixation using a mini-T plate. They were followed up for a minimum of one year and the clinical and radiological results were analyzed. Results: The average time to fracture union was 3.1(3~4) months. There were no complications, such as deep infection or fixation loss. The mean ASES score was 97 points (85~100points) at the last follow up period, and 14 patients had a full range of motion of the shoulder. Conclusion: Open reduction and internal fixation with a mini-T plate for unstable distal clavicle fracture is a good surgical method with good clinical and radiological results.

목적: 불안정성 쇄골 원위부 골절에 대하여 mini-T 금속판을 이용한 수술적 치료를 시행 후 임상적 및 방사선학적 결과를 알아보고자 하였다. 대상 및 방법: 2004년 12월부터 2007년 7월까지 쇄골 원위부 골절 중 Neer 분류 제 2형인 불안정성 골절에 대하여 mini-T 금속판을 이용한 수술을 시행한 환자 중 1년 이상 추시 관찰이 가능하였던 15예를 대상으로 임상적 및 방사선학적 결과를 분석하였다. 결과: 방사선학적 골유합은 평균 3.1개월(3~4개월)에 이루어졌으며 심부 감염이나 고정 실패 등의 합병증은 없었다. 최종 추시 시 미국 견주관절학회 평가 점수(ASES score)는 평균 97점(85~100점)으로 양호한 결과를 보였으며, 견관절의 운동 범위도 1예를 제외하고 모든 예에서 정상으로 회복된 소견을 보였다. 결론: 불안정성 쇄골 원위부 골절에 대하여 mini-T 금속판을 이용한 수술 방법은 양호한 임상적 및 방사선학적 결과를 보여 좋은 수술 방법으로 사료되나 더 많은 증례를 통한 장기적인 결과 분석이 필요하리라 생각된다.

Keywords

References

  1. Ballmer FT, Gerber C: Coracoclavicular screw fixation for unstable fractures of the distal clavicle: a report of five cases. J Bone Joint Surg Br, 73: 291-294, 1991.
  2. Chun JM, Kim SY, Lee KW, Shin SJ, Kim EG:Modified tension band fixation for unstable fracture of the distal clavicle. J Korean Orthop Assoc, 37: 416-420, 2002.
  3. Craig EV: Fracture of the clavicle. In: Rockwood CA Jr, Green DP, Bucholz RW, Heckman JD eds. Fractures in adults. 4th ed. Philadelphia, Lippincott-Raven: 1109-1161, 1996.
  4. Edwards DJ, Kavanagh TG, Flannery MC: Fractures of the distal clavicle: a case for fixation. Injury, 23: 44-46, 1992. https://doi.org/10.1016/0020-1383(92)90125-C
  5. Flinkkila T, Ristiniemi J, Hyvonen P, Hamalainen M: Surgical treatment of unstable fractures of the distal clavicle: a comparative study of Kirschner wire and clavicular hook plate fixation. Acta Orthop Scand, 73:50-53, 2002. https://doi.org/10.1080/000164702317281404
  6. Goldberg JA, Bruce WJ, Sonnabend DH, Walsh WR: Type 2 fractures of the distal clavicle. A new surgical technique. J Shoulder Elbow Surg, 6: 380-382, 1997. https://doi.org/10.1016/S1058-2746(97)90006-9
  7. Hessmann M, Kirchner R, Baumgaertel F, Gehling H, Gotzen L: Treatment of unstable distal clavicular fractures with and without lesions of the acromioclavicular joint. Injury, 27: 47-52, 1996. https://doi.org/10.1016/0020-1383(95)00156-5
  8. Kang HJ, Park KK, Yoon HK, Song HK, Hahn SB:T-plate fixation for unstable fracture of distal Clavicle. J Korean Fracture Soc, 19: 329-334, 2006.
  9. Kao FC, Chao EK, Chen CH, Yu SW, Chen CY, Yen CY: Treatment of distal clavicle fracture using Kirschner wires and tension-band wires. J Trauma, 51:522-525, 2001. https://doi.org/10.1097/00005373-200109000-00016
  10. Kona J, Bosse MJ, Staeheli JW, Rosseau RL: Type II distal clavicle fractures: a retrospective review of surgical treatment. J Orthop Trauma, 4: 115-120, 1990. https://doi.org/10.1097/00005131-199004020-00002
  11. Mizue F, Shirai Y, Ito H: Surgical treatment of comminuted fractures of the distal clavicle using Wolter clavicular plates. J Nippon Med Sch, 67: 32-34, 2000. https://doi.org/10.1272/jnms.67.32
  12. Neer CS 2nd: Fractures of the distal third of the clavicle. Clin Orthop Relat Res, 58: 43-50, 1968.
  13. Neer CS 2nd: Fracture of the distal clavicle with detachment of the coracoclavicular ligaments in adults. J Trauma, 3: 99-110, 1963. https://doi.org/10.1097/00005373-196303000-00001
  14. Nordqvist A, Petersson C, Redlund-Johnell: The natural course of lateral clavicle fracture: 15(11-21) year follow-up of 110 cases. Acta Orthop Scand, 64: 87-91, 1993
  15. Park JH, Kim SG, Suh SW, Nah KW: Operative treatment of type 2 distal clavicle fracture. J Korean fracture Soc, 11: 683-689, 1998.
  16. Rowe CR: An atlas of anatomy and treatment of midclavicular fractures. Clin Orthop Relat Res, 58, 29-42, 1968.
  17. Yamaguchi H, Arakawa H, Kobayashi M: Results of the Bosworth method for unstable fractures of the distal clavicle. Int Orthop, 22: 366-368, 1998. https://doi.org/10.1007/s002640050279

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