Medial Clavicle Fractures

Abstract Background: Patients suffering from medial clavicle fractures combined with displacement need surgical intervention. This research reports the effect of double-plate fixation as an innovative procedure in the treatment of extremely medial clavicle fractures.Methods: Nine patients complaint of extremely medial clavicle fracture were enrolled in this research from Mar 2017 to March 2018. Patients were treated with an open reduction and internal fixation using the double-plate technique. Postoperative X-ray was taken regularly to observe the fracture healing at each visit, and the related complications were also recorded. The rating score systems of Constant Murley score of treated shoulder and contralateral shoulder, Rowe score as well as American Shoulder and Elbow Surgeons (ASES) were questionnaire to evaluate postoperative shoulder joint function.Results: All patients achieved postoperative fracture healing with no complications. Only one patient complained of slight restriction, two patients complained of pain during overhead work, and another patient occurred plate breakage. Meanwhile, the Constant Murley scores of treated and contralateral shoulder were 94.1 and 98.5 points, respectively, indicating the similar shoulder function. Furthermore, the Rowe and ASES scores of the involved shoulder were 96.7 and 96.3 points at average, respectively.Conclusions: It is the first time to introduce the surgical technique of vertical double-plate fixation for stable fixation of extremely medial clavicle fractures, which could provide the surgeons an alternative method for this type of fracture.

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Surgical treatment of displaced medial clavicle fractures using a small T-shaped plate and tension band sutures

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-011-1367-5 ◽

2011 ◽

Vol 131 (12) ◽

pp. 1673-1676 ◽

Cited By ~ 11

Author(s):

Kyung Cheon Kim ◽

Hyun Dae Shin ◽

Soo Min Cha

Keyword(s):

Surgical Treatment ◽

Tension Band ◽

Clavicle Fractures ◽

Medial Clavicle

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Balser Plate Stabilization for Traumatic Sternoclavicular Instabilities or Medial Clavicle Fractures: A Case Series and Literature Review

Orthopaedic Surgery ◽

10.1111/os.12726 ◽

2020 ◽

Vol 12 (6) ◽

pp. 1627-1634

Author(s):

Wei‐lou Feng ◽

Xiao Cai ◽

Shu‐hao Li ◽

Zi‐jun Li ◽

Kun Zhang ◽

...

Keyword(s):

Literature Review ◽

Case Series ◽

Clavicle Fractures ◽

Medial Clavicle ◽

Balser Plate

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Temporary Sternoclavicular Plating for an Unusual Double Clavicle Fracture (Medial Nonunion, Lateral Acute) Complicated by an Intraoperative Pneumothorax

Case Reports in Orthopedics ◽

10.1155/2014/206125 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

John G. Skedros ◽

Alex N. Knight ◽

Chad S. Mears ◽

Tanner D. Langston

Keyword(s):

Surgical Complication ◽

Clavicle Fracture ◽

Complication Rates ◽

Term Outcome ◽

Long Term Outcome ◽

Clavicle Fractures ◽

Preoperative Plan ◽

Medial Clavicle ◽

Two Stages

Double (segmental) clavicle fractures, involving both the medial and lateral aspects of the clavicle, are very uncommon. Even less common is an asynchronous double fracture with one of the fractures being a nonunion. We report the case of a 30-year-old healthy male patient who had an unusual double clavicle fracture (medial nonunion, lateral acute) that occurred in separate traumatic events during motocross (motorcycle) racing. His fractures were treated surgically in two stages. In the first stage a long reconstruction plate was used that spanned onto the sternum and two transcortical screws were placed into the manubrium to enhance purchase for the deficient bone of the medial clavicle. In accordance with the preoperative plan, the medial one-third of the plate and the medial four screws (of the total 13 used) were removed. Although our patient had an excellent final result, he did have an intraoperative pneumothorax that was treated uneventfully with a chest tube. Medial clavicle fractures are difficult to treat, especially if they are nonunions and surgical complication rates can be high. Our case is one of the few that has been described where temporary sternoclavicular plating was successful in achieving an excellent long-term outcome.

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Operative management of periarticular medial clavicle fractures—Report of ten cases

Journal of Trauma and Acute Care Surgery ◽

10.1097/ta.0b013e31820d1354 ◽

2012 ◽

Vol 72 (2) ◽

pp. E1-E7 ◽

Cited By ~ 11

Author(s):

Keisuke Oe ◽

Leander Gaul ◽

Christian Hierholzer ◽

Alexander Woltmann ◽

Masahiko Miwa ◽

...

Keyword(s):

Operative Management ◽

Clavicle Fractures ◽

Medial Clavicle

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Displaced medial clavicle fractures: operative treatment with locking compression plate fixation

European Journal of Trauma and Emergency Surgery ◽

10.1007/s00068-018-1024-6 ◽

2018 ◽

Vol 46 (1) ◽

pp. 207-213 ◽

Cited By ~ 1

Author(s):

Herman Frima ◽

Roderick M. Houwert ◽

Christoph Sommer

Keyword(s):

Operative Treatment ◽

Plate Fixation ◽

Locking Compression Plate ◽

Compression Plate ◽

Clavicle Fractures ◽

Medial Clavicle

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Elastic Intramedullary Nailing of a Medial Clavicle Fracture in a Pediatric Patient

Case Reports in Orthopedics ◽

10.1155/2017/6354284 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4

Author(s):

Michael J. Stark ◽

Michael J. DeFranco

Keyword(s):

Internal Fixation ◽

Pediatric Patient ◽

Intramedullary Nail ◽

Clavicle Fracture ◽

Complete Healing ◽

Sternoclavicular Joint ◽

Successful Outcome ◽

Implant Complications ◽

Clavicle Fractures ◽

Medial Clavicle

Introduction. Injuries to the medial clavicle in pediatric patients typically involve the physis and/or sternoclavicular joint. Clavicle fractures are one of the most common injuries in children, but ones at its medial end are rare. Most medial clavicle fractures are treated nonoperatively, but surgery is indicated in some cases. This original case report is unique in describing the use of an elastic intramedullary nail for fixation of a completely displaced medial clavicle fracture in a pediatric patient. Case Presentation. A pediatric patient sustained a completely displaced fracture of the medial clavicle. The fracture was lateral to the medial physis of the clavicle and did not involve the sternoclavicular joint. Internal fixation was achieved in an anatomic position with an elastic intramedullary nail. The postoperative course was unremarkable and resulted in complete healing of the fracture in an anatomic position. The patient returned to full activities without any pain or dysfunction. Conclusion. The use of elastic intramedullary nails is a viable option for internal fixation of displaced medial clavicle fractures. Knowledge of the surgical anatomy, potential implant complications, and rehabilitation principles is essential to a successful outcome.

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