scholarly journals Treatment of unstable distal clavicle fractures (Neer type IIb): a modified system using a miniature locking plate with a single button

2021 ◽  
Vol 49 (6) ◽  
pp. 030006052110225
Author(s):  
Hua Ying ◽  
Jihuan Wang ◽  
Yuehua Sun ◽  
Kerong Dai ◽  
Chao Yu ◽  
...  
Keyword(s):  
Los Angeles ◽  
Locking Plate ◽  
Constant Score ◽  
Shoulder Injuries ◽  
Distal Clavicle ◽  
Clavicle Fractures ◽  
The Mean ◽  
Neer Type Iib ◽  
Distal Clavicle Fractures

Distal clavicle fractures are common in patients with shoulder injuries. We retrospectively evaluated the clinical outcomes of a novel fixation technique using a miniature locking plate with a single button in patients with distal clavicle fractures associated with coracoclavicular ligament disruption. The study involved seven patients with distal clavicle fractures with a follow-up period of 12 months. All patients were diagnosed with type IIb fractures according to the Neer classification. The distal clavicle fracture was fixed with a miniature locking plate, and the coracoclavicular ligaments were reconstructed using a single button. Functional outcomes were assessed at the final follow-up visit. At the 1-year follow-up, all patients had achieved radiographic union. There were no cases of nonunion or osteolysis. The mean Constant score at the final follow-up was 88 ± 5.13 (range, 78–93); the mean Disabilities of the Arm, Shoulder and Hand score was 19.17 ± 7.70 (range, 11.67–25); and the mean University of California Los Angeles score was 30 ± 2.52 (range, 25–33). In summary, internal fixation using a miniature locking plate and coracoclavicular reconstruction with a single button is a reliable surgical technique for restoring stability in patients with Neer type IIb distal clavicle fractures.

Treatment of Unstable Distal Clavicle Fractures (Neer type IIb): A Modified System using a Miniature Locking Plate with a Single Button

2020 ◽  
Author(s):  
Hua Ying ◽  
Jihuan Wang ◽  
Yuehua Sun ◽  
Kerong Dai ◽  
Chao Yu ◽  
...  
Keyword(s):  
Locking Plate ◽  
Surgical Techniques ◽  
Dash Score ◽  
Shoulder Injuries ◽  
Distal Clavicle ◽  
Coracoclavicular Ligaments ◽  
Clavicle Fractures ◽  
Neer Type Iib ◽  
Distal Clavicle Fractures

Abstract Background: Distal clavicle fractures were common in shoulder injuries. This study described the novel fixation technique using a miniature locking plate with a single button and reported its clinical outcomes obtained in patients with distal clavicle fractures associated with coracoclavicular ligaments disruption. Methods: Seven patients with distal clavicle fractures were included with a follow-up period of 12 months. All patients were diagnosed type IIb fractures according to the Neer classification. Distal clavicle fracture was fixed with a miniature locking plate and coracoclavicular ligaments were reconstructed using a single button. Functional outcomes were assessed at the final follow-up visit.Results: At 1-year follow-up, all patients had achieved radiographic union. There were no cases of nonunion or osteolysis. Mean Constant score at final follow-up was 88±5.13 (range, 78-93). Mean DASH score was 19.17±7.70 (range, 11.67-25). Mean UCLA score was 30±2.52 (range, 25-33).Conclusions: Internal fixation using a miniature locking plate and coracoclavicular reconstruction with a single button were reliable surgical techniques for restoring stability in patients with Neer type IIb distal clavicle fractures.

scholarly journals Locking plate combined with titanium cable for Neer type II distal clavicle fractures

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Fan Zhang ◽  
Qiang Fu ◽  
Yongchuan Li ◽  
Nan Lu ◽  
Aimin Chen ◽  
...  
Keyword(s):  
Complication Rate ◽  
Locking Plate ◽  
Type Ii ◽  
Distal Clavicle ◽  
Union Rate ◽  
Clavicle Fractures ◽  
The Mean ◽  
One Year ◽  
Distal Clavicle Fractures

Abstract Background There is controversy about the optimal strategy treatment of unstable distal clavicle fractures. We explored use of a surgical strategy: combination of a distal clavicle locking plate and a titanium cable. The purpose of this retrospective case series study was to evaluate the clinical outcomes of this new strategy in treating Neer type II distal clavicle fractures. Methods Twenty-one patients with Neer type II distal clavicle fracture were treated with a distal clavicle locking plate and a titanium cable. All patients were followed for at least one year. We retrospectively collected and reviewed follow-up data. The clinical outcomes were assessed for union rate, functional score, and complication rate. Results All patients achieved bony union within 6 months. The average follow-up period was 20.6 months (range12–48 months). The mean Constant score at one-year follow-up was 94.6 ± 3.3 (range 84–98), and the mean UCLA (University of California, Los Angeles) score was 33.3 ± 2.6 (range 27–35). Only one complication (wound infection) was observed during follow-up. Two patients received another operation for implant removal due to local irritation. Conclusions Use of a distal clavicle locking plate in combination with a titanium cable for treatment of Neer type II fractures results in high union rate, a low complication rate, and good shoulder function. This combined surgical strategy can be considered an effective method for treating unstable distal clavicle fractures.

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

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.

scholarly journals Coracoclavicular ligament augmentation at clavicle distal-third fracture treatment

2021 ◽  
pp. 27-31
Author(s):  
Bulent Karslioglu ◽  
Metin Uzun ◽  
Suleyman Semih Dedeoglu ◽  
Yunus Imren ◽  
Ahmet Keskin
Keyword(s):  
Surgical Treatment ◽  
Constant Score ◽  
Full Range ◽  
Bony Union ◽  
Distal Clavicle ◽  
Ligament Augmentation ◽  
Clavicle Fractures ◽  
The Mean

The aim: type 2B clavicle fractures with conoid ligament rupture are considered unstable. Although surgical treatment is recommended as the standard treatment modality for type 2B fractures, there is no consensus about the type of operative treatment. We aimed to evaluate results of surgical treatment with an anatomical distal clavicle plate using CC ligament augmentation. Materials and methods: 15 patients that diagnosed with distal clavicle fractures, who underwent surgery for unstable type 2 fractures. The average patient age was 38 years (range 24–52 years). All patients were male; the right clavicle was injured in 10 patients whereas the left clavicle was injured in 5 cases. Surgical treatment was done with a distal clavicle anatomic locked plate augmentation (ZipTight™) at all cases. The mean follow-up period was 24 months (range, 12–40 months). Results: bony union was achieved at a mean follow-up of 8 weeks (range 6-10 weeks). The mean Constant score was 97 (range, 92–100). There were no complications or no need to second operation. All patients achieved satisfactory full range of shoulder motion. Hardware removal was performed for prominence in one case after the union was completed. Conclusion: the augmented technique reported here, provides early motion, increased stability and anatomic healing compared to other conventional options. We recommend augmentative CC ligament repair techniques over the distal locking anatomic plate for type 2 fractures

scholarly journals Coracoclavicular Ligament Augmentation at Clavicle Distal-Third Fracture Treatment

TRAUMA ◽  
2021 ◽  
Vol 22 (2) ◽  
pp. 17-20
Author(s):  
Bulent Karslioglu
Keyword(s):  
Surgical Treatment ◽  
Constant Score ◽  
Bony Union ◽  
Distal Clavicle ◽  
Early Motion ◽  
Ligament Augmentation ◽  
Clavicle Fractures ◽  
The Mean

Background. Type 2B clavicle fractures with conoid ligament rupture are considered unstable. Although surgical treatment is recommended as the standard treatment modality for type 2B fractures, there is no consensus about the type of operative treatment. Material and methods. 15 patients that diagnosed with distal clavicle fractures, who underwent surgery for unstable type 2 fractures. Surgical treatment was done with a distal clavicle anatomic locked plate augmentation (ZipTight™) at all cases. The mean follow-up period was 24 months (range 12–40 months). Results. Bony union was achieved at a mean follow-up of 8 weeks (range 6–10 weeks). The mean Constant score was 97 (range 92–100). There were no complications or no need to second operation. Conclusions. The augmented technique reported here, provides early motion, increased stability and anatomic healing compared to other conventional options.

scholarly journals Treatment of Acute Acromioclavicular Joint Injuries Using AO Hook Locking Plate

2014 ◽  
Vol 17 (3) ◽  
pp. 114-119 ◽  
Author(s):  
Kyung Cheon Kim ◽  
Yoo Sun Jeon
Keyword(s):  
Los Angeles ◽  
Acromioclavicular Joint ◽  
Locking Plate ◽  
Rating Scale ◽  
Treatment Method ◽  
Unaffected Side ◽  
Joint Injuries ◽  
Coracoclavicular Distance ◽  
The Mean

BACKGROUND: To evaluate clinical and radiological outcome using AO hook locking plate in acute acromioclavicular joint injuries.METHODS: This study was based on patients with Rockwood type 3 or 5 acromioclavicular joint injuries who received surgery with AO hook locking plate from June 2008 until June 2009. Among the 22 patients, 19 of them were male and 3 were female, the mean age was 44.4 +/- 15.57 years (20-72 years) and follow-up period was 15.5 +/- 3.90 months (12-23 months). Preoperatively, postoperatively, and at the final follow-up after the plate removal, both coracoclavicular distances were measured from the anteroposterior radiograph. Also, the Shoulder Rating Scale of the University of California at Los Angeles scores (UCLA scores), the American Shoulder and Elbow Surgeons scores (ASES scores), Constant scores, and the Korean Shoulder Society scores (KSS scores) were measured at the final follow-up to evaluate the function of the shoulder joint.RESULTS: At the time of injury, the mean coracoclavicular distance of the injured side was 17.69 +/- 4.23 mm (9.57-27.82 mm) and the unaffected side was 7.55 +/- 2.20 mm (3.24-13.05 mm). The mean coracoclavicular distance measured postoperatively and at the final follow-up was 6.87 +/- 2.34 mm (4.07-14.13 mm) and 8.47 +/- 2.96 mm (4.37-17.48 mm), respectively. The mean UCLA, ASES, Constant, and KSS scores measured in the final follow-up were 33.5 +/- 1.30 (31-35), 90.8 +/- 8.36 (72-100), 78.6 +/- 8.80 (62-100), and 94.4 +/- 5.08 (84-100) each.CONCLUSIONS: From this short-term research, the surgical treatment using AO hook locking plates in acute acromioclavicular joint injuries is clinically and radiographically satisfying and considered as a useful treatment method.

scholarly journals Comparative analysis of a locking plate with an all-suture anchor versus hook plate fixation of Neer IIb distal clavicle fractures

2020 ◽  
Vol 28 (3) ◽  
pp. 230949902096226
Author(s):  
Joong-Bae Seo ◽  
Kwon-young Kwak ◽  
Jae-Sung Yoo
Keyword(s):  
Suture Anchor ◽  
Constant Score ◽  
Plate Fixation ◽  
Distal Clavicle ◽  
Level Of Evidence ◽  
Fixation Group ◽  
Clavicle Fractures ◽  
Suture Anchor Fixation ◽  
Anchor Fixation ◽  
Distal Clavicle Fractures

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.

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