Fixation of distal clavicle fractures with coracoclavicular instability – A comparative biomechanical study in human cadavers

Christoph J. Laux ◽  
Paul Borbas ◽  
Christina Villefort ◽  
Simon Hofstede ◽  
Lukas Ernstbrunner ◽  
1990 ◽  
Vol 4 (2) ◽  
pp. 115-120 ◽  
Lt. Commander John Kona ◽  
Michael J. Bosse ◽  
John W. Staeheli ◽  
R. L. Rosseau

2020 ◽  
Vol 28 (3) ◽  
pp. 230949902096226
Joong-Bae Seo ◽  
Kwon-young Kwak ◽  
Jae-Sung Yoo

Background: The coracoclavicular fixation with suture anchors adds stability to type IIb distal clavicle fractures fixed with a plate and screws when loaded to failure. The purpose of this study was to compare the clinical and radiological outcomes between the use of a locking compression plate (LCP) with all-suture anchor fixation and hook LCP fixation of Neer IIb distal clavicle fractures. Methods: A total of 82 consecutive patients who underwent plate fixation for Neer IIb distal clavicle fractures were included. The subjects were divided into two groups: an LCP with all-suture anchor fixation group and hook LCP fixation group. For clinical assessments, the American Shoulder and Elbow Surgeons score, Korean shoulder score (KSS), and Constant score were recorded. A percentage of the coracoclavicular distance (CCD%) was used to evaluate fracture reduction. Typical reported complications, such as secondary dislocation, implant failure or loosening, peri-implant fracture, acromion osteolysis, stiffness, peri-anchor osteolysis, postoperative acromioclavicular joint arthrosis, nonunion, or delayed union, were also analyzed. Results: There were no differences in the clinical and radiological outcomes at the final follow-up between the two groups. The period for bone union and CCD% showed no significant differences between groups. Stiffness at 3 months after surgery of LCP with all-suture anchor fixation ( n = 3, 10.7%) was less than that of hook LCP fixation ( n = 17, 31.5%). The complication rate also showed no significant differences between groups. However, LCP with all-suture anchor fixation had anchor-related complications, although it can reduce hook-related complications. Conclusion: LCP with all-suture anchor fixation showed satisfactory outcomes in comparison with hook LCP fixation. In Neer IIb distal clavicle fractures, LCP with all-suture anchor fixation is a useful method for the maintenance of reduction, avoiding implant removal, and hook-related complications. However, anchor fixation should be carefully used, especially in osteoporotic patients or patients with underlying diseases. Level of Evidence: Level III, retrospective study.

2014 ◽  
Vol 49 (5) ◽  
pp. 374 ◽  
Ho-Seung Jeon ◽  
Young-Kyun Woo ◽  
Seok-Ha Hwang ◽  
Seung-Pyo Suh ◽  
Seo-Goo Kang ◽  

Injury ◽  
2009 ◽  
Vol 40 ◽  
pp. S17
M. Savvidis ◽  
A. Boutsiadis ◽  
V. Vraggalas ◽  
G. Gouvas

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