scholarly journals A novel surgical technique for arthroscopic fixation of lateral end clavicle fracture using FiberWire and FiberTape

2020 ◽  
Vol 1 ◽  
pp. 199-206 ◽  
Author(s):  
Ketansinh Pramodsinh Solanki ◽  
Ravi Subramaniam Soundarapandian ◽  
Sarvanan Manoharan
Keyword(s):  
Los Angeles ◽  
Surgical Technique ◽  
Intraoperative Complications ◽  
Clavicle Fracture ◽  
Surgical Techniques ◽  
Shoulder Function ◽  
Secondary Outcome ◽  
Clinical And Radiological Outcome ◽  
Clavicle Fractures ◽  
Radiographic Union

Objectives: Lateral end of clavicle fractures is associated with coracoclavicular ligament disruption and, hence, poses a surgical challenge for the management. Surgical techniques already described have high failure rates and hardware-related complications. The objective of the study is to assess the clinical and radiological outcome of the novel surgical technique of arthroscopic coracoclavicular stabilization and indirect anatomical reduction of the lateral end of clavicle fracture using FiberWire and FiberTape. Materials and Methods: We conducted a retrospective review of 15 consecutive patients with displaced, unstable Neer Type II and V distal clavicle fractures who underwent this surgical technique from 2016 to 2020. Primary outcome variables were radiographic union, patient satisfaction, and post-operative shoulder function. Pre-operative and post-operative University of California, Los Angeles (UCLA), and American Shoulder and Elbow Surgeons (ASES) scores were compared. Secondary outcome variables included intraoperative complications, post-operative complications, and time to radiographic union. Results: In our study, 12 were male patients and three female patients, with a mean age of 43 years. The mean post-operative follow-up period was 23 months. Results were satisfactory in all 15 cases, all 15 were had excellent as per UCLA and ASES score. All fractures healed within a mean period of 6 weeks. Only one patient had developed malunion due to over-tightening of FiberWire, although his functional outcome was not compromised with this. Conclusion: We present a novel surgical technique for fixing displaced distal lateral clavicle with arthroscopic coracoclavicular stabilization with FiberWire and FiberTape that resulted in a 100% union rate and excellent clinical outcomes with minimal complications.

scholarly journals CLINICAL EVALUATION OF THE TREATMENT OF CLAVICLE FRACTURES: INTRAMEDULLARY NAIL × PLATE

2021 ◽  
Vol 29 (1) ◽  
pp. 34-38
Author(s):  
THIAGO MEDEIROS STORTI ◽  
MAURÍCIO SIQUEIRA CAMILO ◽  
RAFAEL FRANCISCO ALVES SILVA ◽  
RAFAEL SALOMON SILVA FARIA ◽  
CAROLINA LIMA SIMIONATTO ◽  
...  
Keyword(s):  
Intramedullary Nail ◽  
Plate Fixation ◽  
Clavicle Fracture ◽  
Nail Plate ◽  
Surgical Techniques ◽  
Pain Scale ◽  
Shoulder Function ◽  
Level Of Evidence ◽  
Plate Group ◽  
Clavicle Fractures

ABSTRACT Objective: Studies confirm the benefit of surgical treatment for fixation of displaced midshaft clavicle fractures. Plate fixation and intramedullary nail are the two most used techniques. Our study seeks to compare these two surgical techniques. Methods: This is a retrospective study, conducted by the evaluation of patients treated for displaced midshaft clavicle fracture with intramedullary nail, and plate and screws. Socioeconomic variables were collected, a visual pain scale questionnaire was applied, the shoulder function was measured using CONSTANT and UCLA scores, and radiography was performed to verify the consolidation and evaluation of the final clavicle shortening. Results: Sixty-five patients were evaluated, 36 (55.4%) of which were subjected to clavicle fixation with plate and screws and 29 (44.6%) with intramedullary nail. The median shortening was 0.1mm for plate and 5.8mm for nail (p = 0.001). The UCLA score shows an average of 35 in the plate group and 35 in the intramedullary group. The median CONSTANT scores were 96.5 for plate and 95 for nail, without significance. In all groups, 13 (20%) complications were registered, 9 fixed with plate and 4 fixed with intramedullary nail. The most common complication was skin erosion with exposure of the synthetic material. Conclusion: The two techniques present satisfactory results for the treatment of displaced midshaft clavicle fractures. Level of Evidence III, Therapeutic Studies Investigating the Results of Treatment.

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

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.

scholarly journals Distal Clavicle Fracture Repair: Clinical Outcomes of a Surgical Technique Utilizing a Combination of Cortical Button Fixation and Coracoclavicular Ligament Reconstruction

2019 ◽  
Vol 7 (9) ◽  
pp. 232596711986792 ◽  
Author(s):  
Gautam P. Yagnik ◽  
Charles J. Jordan ◽  
Raed R. Narvel ◽  
Robert J. Hassan ◽  
David A. Porter
Keyword(s):  
Postoperative Complications ◽  
Surgical Technique ◽  
Ligament Reconstruction ◽  
Distal Clavicle ◽  
Sf 36 ◽  
Cortical Button ◽  
Clavicle Fractures ◽  
The Mean ◽  
Radiographic Union ◽  
Distal Clavicle Fractures

Background: When treated conservatively, unstable distal clavicle fractures demonstrate a high symptomatic nonunion rate. While a variety of surgical techniques have been described, many of these techniques are associated with high failure rates and hardware-related complications. The surgical technique used in this study has shown promising biomechanical results; however, long-term clinical results have not yet been described. Purpose: To assess the clinical and radiological outcomes of a surgical technique for fixing displaced distal clavicle fractures using a combination of cortical button fixation and coracoclavicular (CC) ligament reconstruction. Study Design: Case series; Level of evidence, 4. Methods: We conducted a retrospective review of 22 consecutive patients with displaced, unstable Neer type II or V distal clavicle fractures who underwent this surgical technique from 2012 to 2019. Primary outcome variables were radiographic union, patient satisfaction, and postoperative shoulder function. Preoperative and postoperative University of California, Los Angeles (UCLA), and American Shoulder and Elbow Surgeons (ASES) scores were compared. Secondary outcome variables included intraoperative complications, postoperative complications, time to radiographic union, and preoperative and postoperative CC distance. Quality of life was assessed using preoperative and postoperative 36-Item Short Form Health Survey (SF-36) scores. Results: Nearly all (21/22) patients were available for a final review; 1 patient was lost to follow-up at 2 weeks. All 21 patients achieved radiographic union by 4 months (mean, 60.38 days; range, 41-84 days; 95% CI, 53.80-66.96 days). All patients were satisfied with the surgical procedure and their functional outcome. The mean UCLA score improved from 5.36 (95% CI, 4.14-6.60) preoperatively to 32.52 (95% CI, 30.56-34.48) postoperatively (mean difference, 27.14; P < .001). The mean ASES score improved from 16.23 (95% CI, 9.79-22.67) preoperatively to 88.11 (95% CI, 81.82-94.40) postoperatively (mean difference, 71.91; P < .001). Statistically significant improvements in SF-36 scores were seen in the physical functioning, role limitations due to physical health, pain, social functioning, and emotional well-being categories. There were 3 postoperative complications, including 1 patient with a minor complication secondary to hardware irritation, 1 patient with adhesive capsulitis, and 1 patient with wound dehiscence requiring wound closure. Conclusion: We describe a surgical technique for fixing displaced distal clavicle fractures using a combination of cortical button fixation and CC ligament reconstruction that resulted in a 100% union rate and excellent clinical outcomes with acceptable complications.

scholarly journals Locking or Non-locking Hook Plate in Treatment of Unstable Lateral Clavicle Fracture

2015 ◽  
Vol 20 (3) ◽  
pp. 150-152
Author(s):  
Şerban Al. O. ◽  
Obadâ B.
Keyword(s):  
Medical Records ◽  
Demographic Data ◽  
Clavicle Fracture ◽  
Shoulder Function ◽  
Hook Plate ◽  
Lateral Clavicle Fracture ◽  
Lateral Clavicle ◽  
Clavicular Hook Plate ◽  
Clavicle Fractures

Abstract The purpose of this study was to compare the outcomes and complications of locking or nonlocking clavicular hook plate for fixation of unstable lateral clavicle fractures. All patients with unstable Neer type II lateral clavicle fractures were operated in our hospital from January 2011 to December 2012. The included participants received either locking or nonlocking clavicular hook plate operations. Demographic data, medical records and radiographs were reviewed retrospectively. At the last follow-up, shoulder function was evaluated with Constant-Murley scoring system. Our findings suggest that locking clavicular hook plates are equally useful for treating unstable lateral clavicular fractures, but in face of complicated ones, the locking hook plate would not get more benefits than nonlocking hook plate.

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

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.

scholarly journals Plating versus intramedullary fixation for mid-shaft clavicle fractures: a systemic review and meta-analysis

PeerJ ◽  
2016 ◽  
Vol 4 ◽  
pp. e1540 ◽  
Author(s):  
Yan Gao ◽  
Wei Chen ◽  
Yue-Jv Liu ◽  
Xu Li ◽  
Hai-Li Wang ◽  
...  
Keyword(s):  
Plate Fixation ◽  
Meta Analysis ◽  
Clavicle Fracture ◽  
Shoulder Function ◽  
Intramedullary Fixation ◽  
Systemic Review ◽  
Cochrane Library ◽  
Union Rate ◽  
Fixation Group ◽  
Clavicle Fractures

Background.Plate fixation and intramedullary fixation are the most commonly used surgical treatment options for mid-shaft clavicle fractures; the latter method has demonstrated better performance in some studies.Objectives.Our aim was to critically review and summarize the literature comparing the outcomes of mid-shaft clavicle fracture treatment with plate fixation or intramedullary fixation to identify the better approach.Search Methods.Potential academic articles were identified from the Cochrane Library, MEDLINE (1966-2015.5), PubMed (1966-2015.5), EMBASE (1980-2015.5) and ScienceDirect (1966-2015.5). Gray studies were identified from the references of the included literature.Selection Criteria.Randomized controlled trials (RCTs) and non-RCTs comparing plate fixation and intramedullary fixation for mid-shaft clavicle fracture were included.Data Collection and Analysis.Two reviewers performed independent data abstraction. TheI2statistic was used to assess heterogeneity. A fixed- or random-effects model was used for the meta-analysis.Results.Six RCTs and nine non-RCTs were retrieved, including 513 patients in the intramedullary fixation group and 521 patients in the plating group. No significant differences in terms of the union rate and shoulder function were found between the groups. Patients in the intramedullary fixation group had a shorter operative time, less blood loss, smaller wound size, and shorter union time than those in the plating group. With respect to complications, significant differences were identified for all complications and major complications (wound infection, nonunion, implant failures, transient brachial plexopathy, and pain after 6 months). Similar secondary complications (symptomatic hardware, hardware irritation, prominence, numbness, hypertrophic callus) were observed in both groups.Conclusions.Intramedullary fixation may be superior to plate fixation in the treatment of mid-shaft clavicle fractures, with similar performance in terms of the union rate and shoulder function, better operative parameters and fewer complications.

A simple surgical technique for correcting malunion after midshaft clavicle fracture

2020 ◽  
pp. 175857322093324
Author(s):  
Tom van Essen ◽  
Robert Jan Hillen
Keyword(s):  
Surgical Treatment ◽  
Surgical Technique ◽  
Clavicle Fracture ◽  
Treatment Modalities ◽  
Shoulder Dysfunction ◽  
The Past ◽  
Clavicle Fractures ◽  
New Surgical Technique

Clavicle malunion occurs in two-thirds of all clavicle fractures treated conservatively. It can lead to pain, shoulder dysfunction and cosmetic complaints. Surgical treatment of all midshaft fractures will lead to overtreatment, as not all malunions are symptomatic. In the past, several treatment modalities for correcting malunion of the clavicle have been described, and all have been successful but none have shown superiority. This article describes a new surgical technique with excising a wedge to realign the clavicle malunion.

scholarly journals Effect of Malunited Midshaft Clavicular Fractures on Shoulder Function

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Shachar Shapira ◽  
Zeevi Dvir ◽  
Uri Givon ◽  
Ariel Oran ◽  
Amir Herman ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Range Of Motion ◽  
Treatment Success ◽  
Clavicle Fracture ◽  
Functional Results ◽  
Shoulder Function ◽  
Strength Testing ◽  
Dash Score ◽  
Fracture Function ◽  
Clavicle Fractures

Background and Purpose. Displaced middle third clavicle fractures are traditionally treated non-operatively and heal with residual deformity. Few studies assessed treatment success by using patient-oriented outcome measures or objective muscle strength testing. The purpose of our study was to determine whether clavicle malunion affects functional results. Methods. Union was documented in 25 patients who were treated conservatively due to a displaced mid shaft clavicle fracture. Ten had significant malunion. Patients were examined at least 12 months following the fracture. Function was assessed by DASH and UCLA questionnaires. Clinical assessment included Range of Motion (ROM) measurement, manual and isokinetic muscle strength testing. Healthy shoulder served as a control. Results. Mean follow up time was 38 months. The mean DASH score was 9, mean UCLA score was 31.7. Range of motion was preserved—less than 6° side-to-side difference. Abduction strength reduction in the involved side amounted to 7%. No correlation was found between radiographic malunion and the functional results. Interpretation. Displaced healed middle clavicle fractures result in satisfactory functional results. The average deficits detected in strength and ROM were within the normal limits compared to the non-injured side. Radiographic healing position had no effect on functional outcome.

scholarly journals Evaluation of the modified CC stabilization using LARS artificial ligament in unstable distal clavicle fracture

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 Purpose: Unstable distal clavicle fracture is common, and there is no consensus regarding the gold standard treatment for this fracture. 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 ligament augmentation and reconstruction system (LARS) artificial ligament, and evaluate the clinical and radiographic outcomes. Methods: From January 2009 to June 2018, eighteen patients with acute unstable distal clavicle fractures (type Ⅱb) treated by modified CC stabilization using LARS artificial ligament were retrospectively reviewed. Indexes for evaluation included fracture healing, quality of reduction, and complications (infections, nerve injuries, iatrogenic clavicle or coracoid fracture, the fixation loop failure, loss of reduction, etc.). Shoulder function was evaluated using the Constant-Murley score. Results: The 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 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. The Constant scores were 91.2 ± 6.9 at last. Conclusions: The modified CC stabilization using LARS artificial ligament resulted in a high union rate, satisfactory fracture reduction, a low complication rate, and excellent shoulder function for unstable distal clavicle fractures (type Ⅱb). We consider this simple surgical technique that naturally restores stability to the distal clavicle fracture is an efficient method for treating the fracture.

scholarly journals A novel surgical rotation overlapping craniotomy technique for the management of non-syndromic anterior plagiocephaly

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Mohamed Reda Rady ◽  
Mamdouh Abo Elhassan ◽  
Omar Youssef
Keyword(s):  
Surgical Technique ◽  
Intraoperative Complications ◽  
Surgical Techniques ◽  
Minimally Invasive Techniques ◽  
Pediatric Hospital ◽  
Inclusion Criteria ◽  
Surgical Time ◽  
Anterior Plagiocephaly ◽  
Invasive Techniques

Abstract Background Nonsyndromic anterior plagiocephaly is one of the most common types of craniosynostosis. Different surgical techniques to correct this deformity have been developed with dissatisfaction among many surgeons. In this study, we describe a novel surgical technique to manage this pathology. The inclusion criteria were patients presenting with non-syndromic anterior plagiocephaly below 1 year of age presenting to the Pediatric Hospital in the period between 2016 and 2019. Surgical time, blood loss, and complications were recorded. The follow-up period was at least 1 year postoperative, and cosmetic outcome satisfactory categories were reported. Results Seven patients were included in this study. No intraoperative complications were reported, and no blood replacement was needed in any of the patients. The parents of six patients were completely satisfied (85.7%) with the outcome and partially satisfied in 1 patient (14.3%). Conclusion The results of the described rotational overlapping flap technique are promising and can be considered one of the minimally invasive techniques for the correction of this pathology.

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