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.

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 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 The Radiologic Comparison of Operative Treatment Using a Hook Plate versus a Distal Clavicle Locking Plate of Distal Clavicle Fracture

2018 ◽  
Vol 21 (4) ◽  
pp. 227-233
Author(s):  
Byungil Yoon ◽  
Jae Yoon Kim ◽  
Jae Sung Lee ◽  
Hyoung Seok Jung
Keyword(s):  
Locking Plate ◽  
Metal Removal ◽  
Clavicle Fracture ◽  
Hook Plate ◽  
Plate Versus ◽  
Bony Union ◽  
Distal Clavicle ◽  
Distal Clavicle Fracture ◽  
Plate Group ◽  
Coracoclavicular Distance

BACKGROUND: The purpose of this study was to compare the radiologic results of patients who underwent surgery with a hook plate and a locking plate in distal clavicle fractures.METHODS: Sixty patients underwent surgical treatment for Neer type IIa, IIb, III, and V distal clavicle fracture. Twenty-eight patients underwent fracture fixation with a hook plate and 32 with a locking plate. Coracoclavicular distance was measured on standard anteroposterior radiographs before and after the surgery, and union was confirmed by radiograph or computed tomography taken at 6 months postoperatively. Other radiologic complications like osteolysis was also checked.RESULTS: Bony union was confirmed in 59 patients out of 60 patients, and 1 patient in the hook plate group showed delayed union. Coracoclavicular distance was decreased more in the hook plate group after surgery (p < 0.01). After 6 weeks of the hook plate removal, the coracoclavicular distance was increased a little compared to before metal removal, but there was no difference compared to the contralateral shoulder. Eleven out of 28 patients (39.3%) showed osteolysis on the acromial undersurface in the hook plate group.CONCLUSIONS: Both the hook plate group and the locking plate group showed satisfactory radiologic results in distal clavicle fractures. Both hook plate and locking plate could be a good treatment option if it is used in proper indication in distal clavicle fracture with acromioclavicular subluxation or dislocation.

scholarly journals Results of minimal invasive coracoclavicular fixation by double button lift-up system in Neer type II distal clavicle fractures

2017 ◽  
Vol 25 (1) ◽  
pp. 230949901668472 ◽  
Author(s):  
Süleyman Semih Dedeoğlu ◽  
Yunus İmren ◽  
Haluk Çabuk ◽  
Murat Çakar ◽  
Samet Murat Arslan ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Clavicle Fracture ◽  
Rehabilitation Program ◽  
Minimal Invasive ◽  
X Rays ◽  
Distal Clavicle ◽  
Distal Clavicle Fracture ◽  
Shoulder Scores ◽  
Coracoclavicular Fixation

Aim: We aimed to evaluate clinical and functional outcomes of indirect fracture reduction performed by coracoclavicular fixation with minimal invasive double button lift-up system in Neer type IIa unstable fractures of distal clavicle. Material and methods: 22 patients with Neer type 2 distal clavicle fracture were enrolled in that prospective study. All patients underwent indirect reduction and osteosynthesis performed by coracoclavicular fixation with minimal invasive double button lift-up system. Postoperative follow-up was carried out clinically and radiologically with plain X-rays and utilization of Constant and American Shoulder and Elbow Surgeons Standardized Shoulder Assessment (ASES) shoulder scores. Mean follow-up time was 15 months. A standard sling was applied for 2 weeks, postoperatively. Rehabilitation program was started on postoperative day 1. Results: Mean age was 39 (range: 21–60), 18 of the patients were male. Right dominant extremity was affected in 14 patients. Mean duration of the surgical intervention was 40 min (range: 30–55 min). Mean union time was found to be 14 weeks (range: 7–21 weeks). Mean postoperative ASES and Constant scores were 79.9 (66.9–88.3) and 82.2 (71–100), respectively. The duration of return to normal daily activities were found to be 4.5 months. Any loss of reduction, AC joint arthrosis, and clavicular shortening were not detected in X-rays. Conclusion: This study has demonstrated that indirect osteosynthesis performed by coracoclavicular fixation with double button lift-up system in the treatment of unstable Neer type IIa fractures of the distal clavicle had successful clinical, radiological, and functional outcomes.

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.

scholarly journals Clinical Results of Distal Clavicle Fracture

2004 ◽  
Vol 53 (1) ◽  
pp. 190-194
Author(s):  
Kunitaka Menuki ◽  
Masao Noguchi ◽  
Masato Tomita ◽  
Daisuke Ito ◽  
Kotaro Shiraishi ◽  
...  
Keyword(s):  
Clavicle Fracture ◽  
Clinical Results ◽  
Distal Clavicle ◽  
Distal Clavicle Fracture

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.

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
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