• Title/Summary/Keyword: Distal clavicle

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Surgical Treatment for Type 11 Distal Clavicle Fracture using Mersilene tape and K-wire (Mersilene tape와 K-강선을 이용한 제 II형 원위부 쇄골 골절의 수술적 치료)

  • Byun, Jae-Yong;Kim, Bo-Hyun;Kang, Shin-Taek;Whang, Chan-Ha;Hong, Chang-Wha;Lee, Bum-Sung
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.5 no.2
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    • pp.123-128
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    • 2006
  • Purpose: Surgical reconstruction is usually indicated for type II distal clavicle fracture due to high rate of nonunion and delayed union. We report the clinical outcome of a surgical technique for type II distal clavicle fracture using Mersilen tape and K-wire. Materials and Methods: From 1999 through 2003, this technique has been used on 11 patients with type II distal clavicle fracture. The procedure consist of fracture reduction with a Mersilene tape, repair of torn coracoclavicular ligament, and K-wire fixation of the fracture fragment. All patients with at least 12 months of complete postoperative follow-up were included for functional and radiographic evaluation. We used simple X-ray and UCLA scoring system and constant scoring system for evaluation at last follow up in OPD. Results: Solid union of the fracture could be achieved at 11 weeks after operation in all patients. All patients could return to the same level of preinjury activity. Good and excellent results were obtained in all patients according to UCLA system. Conclusion: This technique was simple procedure and allowed for stable fixation with early mobilization and early return to work and sports.

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Coracoclavicular Ligament Augmentation Using Endobutton for Unstable Distal Clavicle Fractures - Preliminary Report - (불안정성 쇄골 원위부 골절에서의 Endobutton을 이용한 오구 쇄골 인대 보강술 - 예비 보고 -)

  • Cho, Chul-Hyun;Jung, Gu-Hee;Sin, Hong-Kwan;Lee, Young-Kuk;Park, Jin-Hyun
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.1-5
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    • 2011
  • Purpose: The purpose of this study was to evaluate the radiologic and clinical outcomes after operative treatment using endobuttons for unstable distal clavicle fractures. Materials and Methods: Between October 2007 and September 2009, 9 consecutive patients who were followed up for at least more than 12 months after operative treatment using a TightRope$^{(R)}$ were studied. The radiologic results on the serial plain radiographs and the clinical results according to the American Shoulder Elbow Surgeons (ASES) score were analyzed. Result: Bony union was shown in 8 cases (88.9%) and the average time to union was 12.9 (range: 9~16) weeks. The average coracoclavicular distances at the postoperative and final follow-up were 5.6 mm and 6.2 mm, respectively, with no statistically significant difference (p>0.05). The average ASES score was 90.3 (range: 78~96) and the clinical outcomes were 6 excellent, 2 good and one fair. There were no complications such as implant failure or infection except for one case of nonunion due to loss of the initial reduction. Conclusion: A major advantage of TightRope$^{(R)}$ fixation for unstable distal clavicle fractures is that no further surgery is needed to remove the implant. We suggest that this technique provides an alternative for fracture with a distal fragment, which is difficult to fix.

Plate prebending using a three-dimensional-printed model affords effective anatomical reduction in clavicular shaft fractures

  • Hyungsuk Kim;Younsung Jung;Hyun Seok Song
    • Clinics in Shoulder and Elbow
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    • v.26 no.4
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    • pp.397-405
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    • 2023
  • Background: A precontoured plate rarely fits properly within the patient's clavicle and must be bent intraoperatively. This study aimed to determine whether anatomical reduction could be achieved using a plate bent before surgery. Methods: This study included 87 consecutive patients with displaced mid-shaft clavicle fractures who underwent plate fixation and were followed-up for a minimum of 1 year. After exclusions, 39 consecutive patients underwent fixation with a precontoured plate bent intraoperatively (intraoperative bending group), and 28 underwent fixation with the plate bent preoperatively (preoperative bending group). Using free software and a three-dimensional (3D) printer, ipsilateral clavicle 3D-printed models were constructed. Using plain radiographs, the distance between the edge of the lateral inferior cortex and the medial inferior cortex was measured. The angle between the line connecting the inferior cortex edge and the line passing through the flat portion of the superior cortex of the distal clavicle was measured. Results: Mean length differences between the ipsilateral and contralateral clavicle were smaller on both anteroposterior (AP; P=0.032) and axial images (P=0.029) in the preoperative bending group. The mean angular differences on both AP (P=0.045) and axial images (P=0.008) were smaller in the preoperative bending group. No significant differences were observed between the two groups in functional scores at the last follow-up. Conclusions: Smaller differences in length and angle between the ipsilateral and contralateral clavicle, indicative of reduction, were observed in the preoperative bending group. Using the precontoured technique with low expense, the operation was performed more effectively as reflected by a shorter operation time. Level of evidence: III.