• Journal of Trauma and Injury
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• v.29 no.4
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• pp.105-115
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• 2016

Purpose: While all midshaft clavicle fractures have traditionally been treated with conservative measures, recent operative treatment of displaced, communited midshaft clavicle fractures has become more common. Though a recent increase in operative treatment for midshaft clavicle fractures, we have done the operative methods in limited cases. The aim of this study is to present indications, operative techniques and outcomes of the experienced cases that have applied to this limited group over the previous 10 years. Methods: This study consists of a retrospective review of radiological and clinical data from January of 2005 to July of 2015. Operative criteria for midshaft clavicle fractures having considerable risk of bone healing process were 4 groups - a floating shoulder, an open fracture, an associated neurovascular injury, and a nonunion case after previous treatment. Results: The study consisted of 18 patients who had operative treatment for midshaft clavicle fractures in adults. The most common surgical indication was a floating shoulder (10 cases, 55.6%), followed by nonunion (5 cases, 27.8%), an associated neurovascular injury (4 cases, 22.2%), and open fracture (3 cases, 16.7%). All cases were treated by open reduction and internal fixation in anterosuperior position with reconstruction plate or locking compression plate. Bone union was achieved in all cases except 1 case which was done bone resection due to infected nonunion. Mean bone union period was 19.5 weeks. There were no postoperative complications, but still sequelae in 4 cases of brachial plexus injury. Conclusion: We have conducted an open reduction and internal fixation by anterosuperior position for midshaft clavicle fractures in very limited surgical indications for last 10 years. Our treatment strategy for midshaft clavicle fractures showed favorable radiological results and low postoperative complications.

• Journal of the Korean Arthroscopy Society
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• v.15 no.1
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• pp.19-21
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• 2011

Clavicle Hook pate was commonly used in the injury around distal clavicle such as fractures, acromio-clavicular joint injury. We experienced a case of impingement syndrome following operation of distal clavicle fracture using Clavicle Hook plate. So we report this case with a reiview of current literatures.

• Clinics in Shoulder and Elbow
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• v.1 no.1
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• pp.46-50
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• 1998

The superior shoulder suspensory complex is composed of glenoid fossa, coracoid process, coracoclavicular ligament, distal clavicle, acromioclavicular ligament, acromion. Traumatic double disruptions of this complex lose its suspensory action on the shoulder joint and result in functional loss and deformity. Careful radiologic evaluation and appropriate management are required for injuries to this complex. Ipsilateral fractures of clavicle and scapula create unstable anatomic situation on shoulder joint. Conservative treatment usually fails to achieve good functional recovery due to rotator cuff weakness, nonunion, delayed union, malunion and neurovascular injury. Authors studied the result of operative treatment of ipsilateral clavicle and scapular fractures to prevent such complications. Seven cases were treated with open reduction and internal fixations of clavicle alone or clavicle and scapula simultaneously and followed up for nineteen months(twelve months - thirty-eight months). All but one patient showed good or excellent functional result according to the scoring system of Rowe. Poor result was developed in the case which had brain injury. Rigid fixations of clavicle alone or clavicle and scapular fractures both can achieve stable reduction of the fractures and prevent sequelae. We concluded that operative treatment of ipsilateral fractures of clavicle and scapula is safe and yields predictable good results.

• Clinics in Shoulder and Elbow
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• v.1 no.1
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• pp.128-131
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• 1998

Fracture of the clavicle and dislocation of the acromioclavicular joint occur commonly as separate injuries. However, complete acromioclavicular dislocation with an ipsilateral clavicle fracture is quite rare. We experienced a case of acromioclavicular joint dislocation associated with fracture of clavicle and brachial plexus injury treated by open reduction and internal fixation.

• Journal of Trauma and Injury
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• v.32 no.4
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• pp.243-247
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• 2019

Subclavian vein injuries occasionally occur as a sequela of penetrating trauma or vascular access, but have rarely been reported to occur after clavicle fracture. The subclavian vessels are mainly enclosed by the subclavius muscle, the first rib, and the costocoracoid ligament. Therefore, in such cases, subclavian vein injury is rare because of the strcutures surrounding the subclavian vessels. Nevertheless, subclavian vein injuries occasionally show thrombotic manifestations, and thrombosis of the upper limbs constitutes 1-4% of cases of total deep vein thrombosis. Furthermore, to the best of the authors' knowledge, although vessel injuries have been reported after clavicle or rib fractures and nerve injuries to regions such as the brachial plexus, no case involving delayed presentation of isolated subclavian vein stenosis after clavicle fracture due to blunt trauma has yet been reported.

• Clinics in Shoulder and Elbow
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• v.8 no.2
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• pp.131-134
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• 2005

Distal clavicle tunnel widening was observed in coracoclavicular ligament reconstruction with semitendinous tendon autografts in a patient with acromioclavicular joint injury. Acromioclavicular joint separation, in a 44 years-old man was treated by coracoclavicular ligament reconstruction. We have performed x-ray evaluation on 2years 10months after surgery. The immediate postoperative tunnel size was measured 4.5mm in diameter. At postoperative 2years 10month the tunnel diameter was from 9.3 to 11.4mm. But the weightbearing clavicle view showed no significant acromioclavicular joint separation. Moreover the patient complained only minor intermittent shoulder discomfort.

• Journal of Trauma and Injury
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• v.28 no.3
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• pp.219-221
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• 2015

Subclavian injuries in blunt trauma are reported in less than 1% of all arterial injuries or chest related injuries. We report a female 68 yr-old patient whom has visited our emergency center due to a motorcycle traffic accident with complaints of right chest wall and shoulder pain. Her injury severity score was 22 and she was found with a comminuted clavicle fracture and subclavian artery injury. She developed delayed symptoms of pallor, pain and motor weakness with loss of pulse in her right arm. Attempts at intervention failed and thus, she underwent emergency artificial graft bypass from her subclavian artery to her brachial artery. Her postoperative course was uneventful and she is happy with the results. Although rare, a high index of suspicion for the injury must be noted and the inevitable surgical option must always be considered.

• Clinics in Shoulder and Elbow
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• v.13 no.1
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• pp.92-98
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• 2010

Purpose: To analyze results of treating acromioclavicular injuries using clavicle hook plates. Materials and Methods: Between February 2008 and April 2010, 18 patients with acromioclavicular joint injury treated by clavicle hook plates were reviewed. Using the Rockwood classification, 7 dislocations were classified as type III injuries and 11 as type V injuries. Implant removal was done at least 3 months from initial fixation. Simple X-rays were taken for comparing the state of reduction, and clinical outcomes were evaluated by the Korean Shoulder Scoring System and the American Shoulder Elbow Society score. The average follow-up period was 9 months. Results: On weight bearing X-rays, the average coracoclavicular distance showed a 114% increase compared to the contralateral side at the time of injury. It decreased to 23% by the last follow-up. The mean Korean Shoulder Scoring System and the American Shoulder Elbow Society score were 80 and 74 at the last follow-up. Conclusion: The immediate stability these plates provide allows rapid rehabilitation. Clavicle hook plate fixation for acromioclavicular joint dislocation is considered an effective method for ensuring satisfactory results both radiologically and clinically.

• Clinics in Shoulder and Elbow
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• v.19 no.3
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• pp.168-171
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• 2016

Fractures at the lateral end of the clavicle inevitably require surgical treatment as there is high potential for delayed union or nonunion. Acromioclavicular dislocation also requires stable and solid fixation for healing, and surgical treatment is recommended for the maintenance of joint function. The hook plate maintains the biomechanics of the acromioclavicular joint, enabling early range of motion. Therefore, for the past 10 years, the hook plate has been widely used in distal clavicle fractures and acromioclavicular joint injuries. However, the hook plate is associated with several complications, such as proximal clavicle fractures, widening of the hook hole, rotator cuff tear, subacromial impingement, and often acromial fractures. We report on two unusual cases of acromion fracture after hook plate fixation in patients with distal clavicle fracture and acromioclavicular dislocation alongside a literature review.

• Clinics in Shoulder and Elbow
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• v.24 no.2
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• pp.106-109
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• 2021

Displaced fracture of the distal third of the clavicle usually occurs after direct trauma to the shoulder and typically results in superior displacement of the proximal fragment. We report a previously undescribed case of downward displacement of the clavicle caused by a fall on an outstretched hand, and we suggest the mechanism of injury.