Precontoured plate fixation with interfragmentary lag screw use in a middle third clavicle fracture fixation

Abstract Background: Open reduction and pre-contoured locking plate fixation is a popular treatment option for displaced midshaft clavicle fracture. Lag screw and cerclage are two main intraoperative techniques to reduce and fix fragments. However, both lag screw and metallic cerclage have disadvantages. The doubled-suture Nice knot has been reported in many areas of orthopedic surgery for its effectiveness. This study aims to compare the outcomes of comminuted mid-shaft clavicle fractures reduced by Nice knots versus traditional techniques (lag screw or/and metallic cerclage) when bridged with pre-contoured locking plates.Methods: We retrospectively reviewed 101 patients (65 females and 36 males) diagnosed with midshaft clavicle fractures with at least one wedge fragment reduced by either Nice knots or traditional methods and bridged with pre-contoured locking plates between December 2016 and April 2019. Operation time, functional outcomes, pain, patient satisfaction, fracture healing and complications were assessed at a follow-up of 12 to 40 months.Results: The mean age of all the patients was 50.8 years. There were 52 and 49 patients in Nice knot group and traditional group respectively, and no differences between two groups was found in general patient characteristics, fracture type, follow up and injury-to-surgery duration. The Nice knot group had significant less operation time (p < 0.01) than the traditional group (mean and standard deviation [SD], 78.6±19.0 compared with 94.4±29.9 minutes, respectively). For healing time, functional score, pain, satisfaction and complications, there was no significant differences between groups, despite the Nice knot group had slightly better results.Conclusions: Both Nice knots and traditional methods treated for comminuted Robinson type 2B clavicle fractures were effective and safe. And the Nice knots seemed to be superior with significant less operation time.

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Single column plate plus other column lag screw fixation vs. both column plate fixation for anterior column with posterior hemitransverse acetabular fractures – a biomechanical analysis using different loading protocols

Injury ◽

10.1016/j.injury.2020.12.041 ◽

2021 ◽

Author(s):

Huy Le Quang ◽

Werner Schmoelz ◽

Richard A. Lindtner ◽

Dietmar Dammerer ◽

Peter Schwendinger ◽

...

Keyword(s):

Screw Fixation ◽

Plate Fixation ◽

Biomechanical Analysis ◽

Anterior Column ◽

Acetabular Fractures ◽

Lag Screw ◽

Single Column

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Clinical and Radiological Results of Hook Plate Fixation in Acute Acromioclavicular Joint Dislocations and Distal Clavicle Fractures

Clinics in Shoulder and Elbow ◽

10.5397/cise.2018.21.2.95 ◽

2018 ◽

Vol 21 (2) ◽

pp. 95-100

Author(s):

Joo Han Oh ◽

Seunggi Min ◽

Jae Wook Jung ◽

Hee June Kim ◽

Jae Yoon Kim ◽

...

Keyword(s):

Plate Fixation ◽

Clavicle Fracture ◽

Hook Plate ◽

Distal Clavicle ◽

Ac Joint ◽

Joint Dislocation ◽

Group I ◽

Joint Dislocations ◽

Ac Joint Dislocation ◽

Group Ii

BACKGROUND: The purpose of this study was to evaluate the clinical outcomes and complications of hook plate fixation in acromioclavicular (AC) joint dislocations and distal clavicle fractures.METHODS: We retrospectively reviewed a series of 60 consecutive patients with hook plate fixation for AC joint dislocation (group I) and distal clavicle fracture (group II). Groups I and II had 39 and 21 patients, respectively. Clinical results were evaluated using the pain visual analogue scale (VAS), simple shoulder test, and Constant-Murley scores. In addition, subacromial erosion and stiffness were evaluated as complications.RESULTS: At the removal, the pain VAS was 2.69 ± 1.30 and 4.10 ± 2.14 in groups I and II, respectively, which were significantly different (p=0.003). The simple shoulder test score was 9.59 ± 1.60 and 7.81 ± 2.67 in groups I and II, respectively, which were also significantly different (p=0.002). Subacromial erosion was significantly more frequent in group II (14/21 patients, 66.7%) than in group I (15/39 patients, 38.5%) (p=0.037), and stiffness was also higher in group II (17/21 patients, 81.0%) than in group I (22/39 patients, 56.4%), but it was not significant.CONCLUSIONS: Hook plate fixation showed good clinical and functional results for the treatment of acute unstable AC joint dislocation and distal clavicle fracture. But, in distal clavicle fractures, there are more subacromial erosion and stiffness compare with acute unstable AC joint dislocation.

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Single-center Experience in the Treatment of Extremely Medial Clavicle Fractures with Vertical Fixation of Double-plate

10.21203/rs.2.15445/v1 ◽

2019 ◽

Author(s):

He Liu ◽

Ziyan Zhang ◽

Baoming Yuan ◽

Guangkai Ren ◽

Junlong Yu ◽

...

Keyword(s):

Fracture Healing ◽

Plate Fixation ◽

Clavicle Fracture ◽

Shoulder Function ◽

Single Center Experience ◽

Clavicle Fractures ◽

Postoperative Fracture ◽

Medial Clavicle ◽

First Time ◽

Contralateral Shoulder

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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First Metatarsal-Phalangeal Joint Arthrodesis: A Biomechanical Assessment of Stability

Foot & Ankle International ◽

10.1177/107110070302400405 ◽

2003 ◽

Vol 24 (4) ◽

pp. 332-337 ◽

Cited By ~ 123

Author(s):

Joel Politi ◽

John Hayes ◽

Glen Njus ◽

Gordon L. Bennett ◽

David B. Kay

Keyword(s):

Plate Fixation ◽

Kirschner Wire ◽

High Rate ◽

Fixation Method ◽

Materials Testing ◽

Dorsal Plate ◽

Kirschner Wires ◽

First Metatarsal ◽

Lag Screw ◽

Kirschner Wire Fixation

Background: First metatarsal phalangeal joint (MTP) arthrodesis is a commonly performed procedure for the treatment of hallux rigidus, severe and recurrent bunion deformities, rheumatoid arthritis and other less common disorders of the joint. There are different techniques of fixation of the joint to promote arthrodesis including oblique lag screw fixation, lag screw and dorsal plate fixation, crossed Kirschner wires, dorsal plate fixation alone and various types of external fixation. Ideally the fixation method should be reproducible, lead to a high rate of fusion, and have a low incidence of complications. Methods: In the present study, we compared the strength of fixation of five commonly utilized techniques of first MTP joint arthrodesis. These were: Surface excision with machined conical reaming and fixation with a 3.5 mm cortical interfragmentary lag screw. Surface excision with machined conical reaming and fixation with crossed 0.062 Kirschner wires. Surface excision with machined conical reaming and fixation with a 3.5 mm cortical lag screw and a four hole dorsal miniplate secured with 3.5 mm cortical screws. Surface excision with machined conical reaming and fixation with a four hole dorsal miniplate secured with 3.5 mm cortical screws and no lag screw. Planar surface excision and fixation with a single oblique 3.5 mm interfragmentary cortical lag screw. Testing was done on an Instron materials testing device loading the first MTP joint in dorsiflexion. Liquid metal strain gauges were placed over the joint and micromotion was detected with varying loads and cycles. Results: The most stable technique was the combination of machined conical reaming and an oblique interfragmentary lag screw and dorsal plate. This was greater than two times stronger than an oblique lag screw alone. Dorsal plate alone and Kirschner wire fixation were the weakest techniques. Conclusions: First MTP fusion is a commonly performed procedure for the treatment of a variety of disorders of the first MTP joint. The most stable technique for obtaining fusion in this study was the combination of an oblique lag screw and a dorsal plate. This should lead to higher rates of arthrodesis.

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Medial Clavicle Fracture Fixation Including the Sternum

JBJS Case Connector ◽

10.2106/jbjs.cc.20.00778 ◽

2021 ◽

Vol 11 (2) ◽

Author(s):

Matthew J Schultz ◽

Eric A Barcak

Keyword(s):

Fracture Fixation ◽

Clavicle Fracture ◽

Medial Clavicle

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Trends in the management of fractures of the distal radius in Ireland

The Bone & Joint Journal ◽

10.1302/0301-620x.101b12.bjj-2018-1615.r3 ◽

2019 ◽

Vol 101-B (12) ◽

pp. 1550-1556 ◽

Cited By ~ 2

Author(s):

R. Mc Colgan ◽

David M. Dalton ◽

Adrian J. Cassar-Gheiti ◽

Ciara M. Fox ◽

Michael E. O’Sullivan

Keyword(s):

Distal Radius ◽

Fracture Fixation ◽

Emergency Surgery ◽

Open Reduction ◽

Plate Fixation ◽

Kirschner Wire ◽

Acute Fracture ◽

Wire Fixation ◽

Increasing Trend ◽

Adult Inpatient

Aims The aim of this study was to examine trends in the management of fractures of the distal radius in Ireland over a ten-year period, and to determine if there were any changes in response to the English Distal Radius Acute Fracture Fixation Trial (DRAFFT). Patients and Methods Data was grouped into annual intervals from 2008 to 2017. All adult inpatient episodes that involved emergency surgery for fractures of the distal radius were included Results In 2008 Kirschner-wire (K-wire) fixation accounted for 59% of operations for fractures of the distal radius, and plate fixation for 21%. In 2017, the rate of K-wire fixation had fallen to 30%, and the proportion of patients who underwent plate fixation had risen to 62%. Conclusion There is an increasing trend towards open reduction and internal fixation for fractures of the distal radius in Ireland. This has been accompanied by a decrease in popularity for K-wire fixation. DRAFFT did not appear to influence trends in the management of fractures of the distal radius in Ireland. Cite this article: Bone Joint J 2019;101-B:1550–1556

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