Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
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Arthroscopic Stabilization for Displaced Lateral Clavicular Fractures: Can It Restore Anatomy?

  • Khan, Prince Shanavas (Department of Orthopaedic Surgery, Pariyaram Medical College) ;
  • Yoo, Yon-Sik (Department of Orthopaedic Surgery, Hallym University Dongtan Sacred Heart Hospital) ;
  • Kim, Byung-Su (Department of Orthopaedic Surgery, Hallym University Dongtan Sacred Heart Hospital) ;
  • Lee, Seong-Jin (Department of Orthopaedic Surgery, Hallym University Dongtan Sacred Heart Hospital) ;
  • Ha, Jong Mun (Department of Orthopaedic Surgery, Hallym University Dongtan Sacred Heart Hospital)
  • Received : 2015.11.24
  • Accepted : 2016.02.10
  • Published : 2016.09.30
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Abstract

Background: The purpose of our study was to evaluate the accuracy of reduction based on postoperative computed tomography (CT) images after arthroscopic stabilization using tightrope system for unstable distal clavicle fracture. Methods: Twelve patients with distal clavicle fracture combined with coracoclavicular (CC) ligament injury (type II, V) who received arthroscopically assisted fixation using a flip button device were evaluated for accuracy of reduction using 3-dimensional postoperative CT scan by measuring the degree of distal clavicular angulation and clavicular shortening. Results: Immediate postoperative plain radiograph confirmed restoration of the CC distance (CCD) in 10 patients. At final follow-up, the CCD remained reduced anatomically on plain radiographs in these patients. All patients showed excessive posterior angulation and shortening compared to the opposite side. The average Constant score recovered to 94.8 at final follow-up. Conclusions: Indirect reduction and arthroscopic subacromial approach with flip button fixation of unstable distal clavicle fractures demonstrated favorable clinical results despite unavoidable posterior angulation of distal clavicle and shortening the total length of clavicle.

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References

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  2. Treatment of Unstable Distal Clavicle Fractures With Multiple Steinmann Pins—A Modification of Neerʼs Method vol.31, pp.9, 2017, https://doi.org/10.1097/BOT.0000000000000850