scholarly journals TENSION BAND WIRING (TBW) OF DISTAL END CLAVICLE : A FORGOTTEN TECHNIQUE : SIMPLER, CHEAPER AND BETTER

2020 ◽  
Vol 8 (5_suppl5) ◽  
pp. 2325967120S0006
Author(s):  
S Zufahrizzat ◽  
AS Nadzim ◽  
O Saifudin ◽  
Rauf A Abdul
Keyword(s):  
Clavicle Fracture ◽  
Fracture Site ◽  
Tension Band ◽  
Left Shoulder ◽  
Rigid Fixation ◽  
Type Ii ◽  
Distal Clavicle ◽  
Distal Clavicle Fracture ◽  
Advantages And Disadvantages ◽  
K Wires

Clavicle fracture is a common injury, and can be classified into middle third, medial third, and distal third fractures. Only 10-15% of clavicle fracture occur in the distal third segment. Neer classified the distal clavicle fracture into five types ; type II and V are unstable and requiring fixation . Various common methods of stabilizations are introduced such as K-wiring , tension band fixation , plate fixation, osteosynthesis with hook plate and coracoclavicular screw however all those operative methods have their own advantages and disadvantages. Materials and Methods: We presented a case of 21 years old male with left shoulder pain after motor vehicle accident. Examination revealed tenderness on his left shoulder, and radiograph showed fracture of distal end left clavicle Neer type II, requiring fixation. He was counselled for lateral extension clavicle locking plate but unable to pay due to financial constraint. Results: The patient underwent open reduction and internal fixation using Kirschner wire with tension band fixation . The fracture site was visualized and the hematoma was curetted and washed. The fracture was reduced and fixed with two 1.4 mm trans-acromial Krischner wires and the reduction was checked with an image intensifier. Then the TBW is applied using stainless steel wire size 1.0 . The K-wires are bent beneath the skin. Sling immobilization is used for 2 weeks after the operation. Unrestricted tolerable shoulder motion is permitted. Stretched and exertional exercise is allowed after radiography shows osseous union and the implants are removed. Discussions: TBW is widely employed to treat limb fractures, such as patella and olecranon fracture but seldom used for distal clavicle nowadays. The advantages of TBW are higher antirotation and antibending force compared with that in K-wire fixation and lower profile compared with the bone plate, which reduces tendon irritation and prominent implant. The use of K-wires and TBW also required only the exposure of the fracture site. The soft tissue around the clavicle incurred little damage, leading to a lower infection rate. In addition, the use of K-wires and TBWs can provide a more rigid fixation than K-wires only. Rigid fixation with little complication contributes to good results . Conclusion: Surgical management is recommended for unstable distal clavicle fracture. TBW can be preferred because of the simplicity of the procedure, low cost, simple hardware, high union rate and easy availability of the implant.

Tension Band Wiring for Distal Clavicle Fracture: Radiologic Analysis and Clinical Outcome

2014 ◽  
Vol 27 (2) ◽  
pp. 127 ◽  
Author(s):  
Seong Cheol Moon ◽  
Chul Hee Lee ◽  
Jong Hoon Baek ◽  
Nam Su Cho ◽  
Yong Girl Rhee
Keyword(s):  
Clinical Outcome ◽  
Clavicle Fracture ◽  
Tension Band ◽  
Tension Band Wiring ◽  
Distal Clavicle ◽  
Distal Clavicle Fracture

Coracoclavicular Screw Fixation and Tension Band Wiring in Treatment of Distal Clavicle Fracture

2013 ◽  
Vol 26 (1) ◽  
pp. 1
Author(s):  
Dae Gyu Kwon ◽  
Tong Joo Lee ◽  
Kyung Ho Moon ◽  
Byoung Ki Shin ◽  
Min Su Woo
Keyword(s):  
Screw Fixation ◽  
Clavicle Fracture ◽  
Tension Band ◽  
Tension Band Wiring ◽  
Distal Clavicle ◽  
Distal Clavicle Fracture

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

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.

scholarly journals Anatomical Locking Plate with Additional K-wire Fixation for Distal Clavicle Fracture

2017 ◽  
Vol 20 (4) ◽  
pp. 230-235
Author(s):  
Woo Dong Nam ◽  
Sung Hoon Moon ◽  
Ki Yong Choi
Keyword(s):  
Locking Plate ◽  
Clavicle Fracture ◽  
Clinical Results ◽  
Proximal Fragment ◽  
Type Ii ◽  
Distal Clavicle ◽  
Distal Clavicle Fracture ◽  
Wire Fixation ◽  
Coracoclavicular Distance

BACKGROUND: Neer type II distal clavicle fractures have the drawback of coracoclavicular instability and insufficient distal bony fragment, thereby making it difficult to achieve adequate fixation. Although various surgical treatments have been described for Neer type II fracture, the optimal treatment remains controversial. This study reports the clinical results and usefulness of anatomical locking plate with additional K-wire fixation.METHODS: A totally of 21 patients with type II distal clavicle fracture were included in the study. The surgical procedure reduced the fracture temporarily; it included insertion of one or two K-wire from the lateral margin of the distal fragment to the proximal fragment through the fracture site, followed by application and fixation of the locking plate. The bony union and migration of K-wire was evaluated in the follow-up radiography. The coracoclavicular distance and acromioclavicular joint arthrosis were assessed at the final follow-up. The Constant Score (CS) and Korean Shoulder Score (KSS) were evaluated for clinical scoring.RESULTS: Bone union was achieved in all cases. At the final follow-up, coracoclavicular distance of the injured shoulder was increased, as compared to the intact shoulder (p=0.002), with no accompanying clinical symptoms. No K-wire migration was observed. At the final follow-up, K-wire irritation was observed in two cases and acromioclavicular arthrosis in one case, with no other adverse effects. Pain visual analogue scale, CS, and KSS were improved in all cases.CONCLUSIONS: The method of anatomical locking plate with additional K-wire fixation could be useful in achieving beneficial clinical results.

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

2009 ◽  
Vol 12 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Jae-Kwang Yum ◽  
Sang-Lim Lee ◽  
Ho-Jong Ra
Keyword(s):  
Plate Fixation ◽  
Clavicle Fracture ◽  
Type Ii ◽  
Distal Clavicle ◽  
Distal Clavicle Fracture

Treatment of Distal Clavicle Fracture Using Kirschner Wires and Tension-Band Wires

2001 ◽  
Vol 51 (3) ◽  
pp. 522-525 ◽  
Author(s):  
Feng-Chen Kao ◽  
En-Kai Chao ◽  
Chih-Hwa Chen ◽  
Shang-Won Yu ◽  
Chao-Yu Chen ◽  
...  
Keyword(s):  
Clavicle Fracture ◽  
Tension Band ◽  
Distal Clavicle ◽  
Kirschner Wires ◽  
Distal Clavicle Fracture

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

2016 ◽  
Vol 29 (1) ◽  
pp. 55 ◽  
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

scholarly journals The Floating Acromion: A Rare and Previously Unreported Injury Possibly Requiring Surgical Stabilization

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Simone J. M. Stoots ◽  
Robert J. Derksen
Keyword(s):  
Surgical Treatment ◽  
Severe Pain ◽  
Clavicle Fracture ◽  
Frozen Shoulder ◽  
Radiographic Evaluation ◽  
Left Shoulder ◽  
Distal Clavicle ◽  
Distal Clavicle Fracture ◽  
Lateral Clavicle ◽  
Acromion Fracture

Acromion fractures are increasingly seen as a postoperative complication following reversed shoulder arthroplasty. However, traumatic fractures of the acromion, usually caused by direct trauma, are rare. Therefore, the current literature lacks standardized clinical guidelines regarding the surgical treatment of these kinds of fractures. We present a traumatic acromion fracture and concomitant distal clavicle fracture, resulting in a so-called “floating acromion.” A fifty-four-year-old female patient was presented at the Emergency Department following a fall from the stairs. She complained of severe pain in the left shoulder. Radiographic evaluation of the left shoulder revealed an acromion fracture and concomitant distal clavicle fracture. Initially, since there was no dislocation, this “floating acromion” was treated conservatively. However, after 4 weeks, no improvement in pain was seen and a control CT scan revealed no callus formation. Considering the possibility that this could be a biomechanically unstable injury, together with the persistent severe pain, it was decided to proceed with surgical treatment. A lateral clavicle plate was used to stabilize the acromion fracture. Postoperatively, the patient was provided with a sling. She was regularly seen at the outpatient clinic. After two weeks of circumduction exercises, she was allowed to build up active movement under the supervision of a shoulder physiotherapist. Nevertheless, she developed a frozen shoulder. However, our patient fully recovered with complete restoration of shoulder function. Therefore, for operative management of acromion fractures, we suggest the use of a lateral clavicle plate which fits remarkably well on the lateral spine and acromion.

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