Peri-implant distal clavicle fracture: Case report (overlaying plate fixation: Solution for peri-implant clavicle fractures)

A 59-year-old woman was admitted three times over a six-month period with recurrent upper extremity deep venous thrombosis (UEDVT). It was determined that this patient was suffering from an unusual presentation of Paget-Schröetter syndrome secondary to a 20-year-old non-union of a midshaft clavicle fracture. Following thrombolysis the patient underwent resection and plate fixation of the clavicle fracture non-union. Despite the anatomic proximity of the subclavian vessels to the clavicle, vascular complications from fracture are rare. Treatment of midshaft clavicle fractures is often non-operative. Non-union rates are generally less than 10%, and easily treated secondarily without complication. Clavicular pseudo-arthroses from trauma have been implicated in the development of the thoracic outlet syndromes, however, onset 20 years after fracture has never before been reported.

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Shoulder Impingement, An Uncommon Complication of Distal Clavicle Fracture Treated Arthroscopically: A Case Report

Malaysian Orthopaedic Journal ◽

10.5704/moj.1311.002 ◽

2013 ◽

Vol 7 (3) ◽

pp. 18-20

Author(s):

CS Wang ◽

Bea KC ◽

Zulkiflee O

Keyword(s):

Case Report ◽

Clavicle Fracture ◽

Distal Clavicle ◽

Distal Clavicle Fracture ◽

Shoulder Impingement ◽

Uncommon Complication

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Anatomic Locking Plate Fixation and Coracoclavicular Stabilisation with Multistrand Titanium Cable for Unstable Distal Clavicle Fracture

Journal of Medical Imaging and Health Informatics ◽

10.1166/jmihi.2021.3581 ◽

2021 ◽

Vol 11 (5) ◽

pp. 1477-1480

Author(s):

Zhong-Guo Liu ◽

Yue-Wei Yu ◽

Huang-Lin Xie ◽

Qing-Xin Xie

Keyword(s):

Fracture Healing ◽

Locking Plate ◽

Clavicle Fracture ◽

Clinical Effects ◽

Distal Clavicle ◽

Distal Clavicle Fracture ◽

Clavicle Fractures ◽

Anatomic Locking Plate ◽

Distal Clavicle Fractures

Objective: The aim of this study was to introduce a modified surgical procedure using anatomic locking plate (ALP) fixation and coracoclavicular (CC) stabilisation with multistrand titanium cable (MTC) to repair unstable distal clavicle fractures, and to estimate clinical effects of these people. Materials and methods: Between July 2016 and April 2018, we treated 7 patients with unstable distal clavicle fracture by ALP fixation and CC stabilisation with MTC. After the surgery, we followed up every patient for at least 24 months and analysed their clinical results. Results: The average term required for fracture healing was 9.9 (range, 9–12 weeks) and all cases are successful in fracture healing. The average Constant score was 94.6 points (range, 92–100) at the last follow-up; the modified University of California, Los Angeles (UCLA) shoulder rating scale was 33.4 points (range, 31–35) at the last follow-up. There was no infection, hardware failure and iatrogenic fracture in all the cases. Conclusions: ALP fixation and CC stabilisation with MTC is a really good method for the treatment of unstable distal clavicle fractures. This surgical technique can provide stable fixation for early functional exercise, and prevent extra shoulder joint damage.

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Treatment of distal clavicle fracture of Neer type II with locking plate in combination with titanium cable under the guide

Scientific Reports ◽

10.1038/s41598-021-84601-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Jun Wang ◽

Jie Guan ◽

Minbo Liu ◽

Yongfeng Cui ◽

Yuhang Zhang

Keyword(s):

Locking Plate ◽

Clavicle Fracture ◽

Operation Time ◽

Hook Plate ◽

Type Ii ◽

Distal Clavicle ◽

Distal Clavicle Fracture ◽

Plate Group ◽

Clavicle Fractures ◽

Distal Clavicle Fractures

AbstractTo observe and compare the curative effect of a locking plate plus titanium cable under the Guide device and clavicular hook plate in the treatment of Neer type II distal clavicle fractures. A prospective cohort study was conducted to analyse the clinical data of 36 patients with distal clavicle fractures from January 2016 to January 2019. The results were analysed. According to the random number method, the patients were divided into two groups: the titanium cable group (fixed with a titanium cable in combination with a locking plate) and hook plate group (fixed with a clavicular hook plate only). Under the guidance of a special device (for which a patent was obtained), in the titanium cable group, the coracoclavicular ligament was fixed with tension reduction, and then the distal clavicular fracture was fixed with a locking plate. In the hook plate group, the distal clavicle fracture was fixed with a hook plate. The incision length, operation time, bleeding volume and VAS score before, 1 week after and 1 year after the operation were compared between the two groups. The effect of the operation was evaluated by the Constant-Murley score before and 1 year after the operation. X-ray films were taken 2 days, 3 months, half a year and 1 year after the operation to observe the reduction and healing of fractures. At the same time, complications were recorded. The amount of bleeding was the same in the two groups. The operation time in the hook plate group was relatively short, and the difference was statistically significant (P < 0.05). The VAS score in the titanium cable group was significantly lower than that in the hook plate group one year after the operation. The Constant-Murley score in the titanium cable group and hook plate group was significantly higher 1 year after the operation. The number of postoperative complications in the titanium cable group was significantly lower than that in the hook plate group. The treatment of Neer type II distal clavicle fractures with a titanium cable plus a locking plate has a good curative effect, few complications and good postoperative recovery and thus is worth popularizing.

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

Clinics in Shoulder and Elbow ◽

10.5397/cise.2009.12.1.001 ◽

2009 ◽

Vol 12 (1) ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Jae-Kwang Yum ◽

Sang-Lim Lee ◽

Ho-Jong Ra

Keyword(s):

Plate Fixation ◽

Clavicle Fracture ◽

Type Ii ◽

Distal Clavicle ◽

Distal Clavicle Fracture

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Periprosthetic Fracture after Hook Plate Fixation in Neer Type II Distal Clavicle Fracture: A Report of 3 Cases

Journal of the Korean Fracture Society ◽

10.12671/jkfs.2016.29.1.55 ◽

2016 ◽

Vol 29 (1) ◽

pp. 55 ◽

Cited By ~ 2

Author(s):

Kyung Yong Kim ◽

Joon Yub Kim ◽

Won Bok Lee ◽

Myong Gon Jung ◽

Jeong Hyun Yoo ◽

...

Keyword(s):

Periprosthetic Fracture ◽

Plate Fixation ◽

Clavicle Fracture ◽

Hook Plate ◽

Type Ii ◽

Distal Clavicle ◽

Distal Clavicle Fracture

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A Distal Clavicle Fracture With Unusual Displacement of the Medial Part: A Case Report

Emergency Medicine - Open Journal ◽

10.17140/emoj-2-128 ◽

2016 ◽

Vol 2 (2) ◽

pp. 39-41

Author(s):

Suzanne F. van Rijn ◽

◽

Laurens Kaas ◽

Annechien Beumer ◽

Ronald Boer ◽

...

Keyword(s):

Case Report ◽

Clavicle Fracture ◽

Medial Part ◽

Distal Clavicle ◽

Distal Clavicle Fracture

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Evaluation of Modified CC Stabilization Using LARS Artificial Ligament in Unstable Distal Clavicle Fracture

10.21203/rs.3.rs-27532/v1 ◽

2020 ◽

Author(s):

Yongchuan Li ◽

Nan Lu ◽

Di Shen ◽

Fan Zhang ◽

Jiajia Lu ◽

...

Keyword(s):

Clavicle Fracture ◽

Shoulder Function ◽

Distal Clavicle ◽

Artificial Ligament ◽

Distal Clavicle Fracture ◽

Loss Of Reduction ◽

Clavicle Fractures ◽

Lars Artificial Ligament ◽

Distal Clavicle Fractures

Abstract Background: Unstable distal clavicle fracture is common, and there is no consensus regarding the gold standard treatment. The purpose of this study was to report a new surgical technique for the treatment of unstable distal clavicle fracture with modified coracoclavicular (CC) stabilization using a ligament augmentation and reconstruction system (LARS) artificial ligament, and to evaluate the clinical and radiographic outcomes.Patients and methods: We retrospectively reviewed 18 patients with acute unstable distal clavicle fractures (type Ⅱb) treated between January 2009 and June 2018 with modified CC stabilization using LARS artificial ligament. Indexes for evaluation included fracture healing, quality of reduction, and presence of complications (e.g., infections, nerve injuries, iatrogenic clavicle or coracoid fracture, the fixation loop failure, or loss of reduction). Shoulder function was evaluated using the Constant-Murley score.Results: Patients were assessed at a mean time of 31.8 months follow-up. All 18 patients experienced radiographic union. Follow-up radiographs showed anatomical reduction in 15 patients and slight loss of reduction in 3 patients. There were 2 cases of calcification of the CC ligament, 1 case of degenerative change around the acromioclavicular (AC) joint, and 1 case of clavicular osteolysis around screws noted during the follow-up. At the final follow-up, Constant scores were 91.2 ± 6.9.Conclusions: Treating unstable distal clavicle fractures (type Ⅱb) with modified CC stabilization using LARS artificial ligament resulted in a high union rate, satisfactory fracture reduction, a low complication rate, and excellent shoulder function. We consider this simple surgical technique that naturally restores stability to the distal clavicle fracture is an efficient method for treating the fracture.

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