Addition of a Suture Anchor for Coracoclavicular Fixation to a Superior Locking Plate Improves Stability of Type IIB Distal Clavicle Fractures

Madsen, Wes; Yaseen, Zaneb; LaFrance, Russell; Chen, Tony; Awad, Hani A.; Maloney, Michael D.; Voloshin, Ilya

doi:10.1016/j.arthro.2013.02.024

Cited by 49 publications

(52 citation statements)

References 25 publications

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“…13,16,21) Furthermore, a recent biomechanical study demonstrated that CC fixation adjunct to locking plate improved stability of type IIB fractures in cadaveric specimens. 22) Nevertheless, there was a case of nonunion in our case series (Fig. 4B).…”

Section: Discussionmentioning

confidence: 61%

Coracoclavicular Ligament Suture Augmentation with Anatomical Locking Plate Fixation for Distal Clavicle Fracture

Lim¹,

Shon²,

Ryu³

et al. 2014

Clinics in Shoulder and Elbow

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Background: For Neer type IIB fracture of distal clavicle with coracoclavicular ligament injury, various surgical treatments have been used in literatures. However, there was no consensus on the optimal treatment. The aim of this study is to report the clinical and radiological results of open reduction and internal fixation of unstable distal clavicle fracture and suture augmentation of disrupted coracoclavicular ligament. Methods: A prospective study was performed in 23 patients with Neer type IIB distal clavicle fracture in Seoul Medical Center, Eulji Hospital, and National Medical Center. Firstly, suture anchors are inserted in the base of coracoid process and preliminary reduction was achieved by tie-off of three suture limbs around the clavicle. Then, the final fixation was completed with anatomical locking plate. Bony union and the distance between coracoclavicular ligaments were evaluated. Clinical results and complications including stiffness and secondary procedures were evaluated. Results: Bony union was achieved in all cases except one (22 of 23). At mean 14.9 months, no significant difference in the mean coracoclavicular distance was observed compared to uninjured shoulder (8.2 ± 7.9 mm versus 7.3 ± 3.4 mm, p=0.14). Pain visual analogue scale, American Shoulder and Elbow Surgeons score, Constant score, and Disabilities of the Arm, Shoulder and Hand score were 0.5, 83.4, 78.5, and 6.2, respectively. Revision surgery was performed in one case of nonunion. Four patients who complained of skin irritation underwent implant removal.

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Section: Discussionmentioning

confidence: 61%

Coracoclavicular Ligament Suture Augmentation with Anatomical Locking Plate Fixation for Distal Clavicle Fracture

Lim¹,

Shon²,

Ryu³

et al. 2014

Clinics in Shoulder and Elbow

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“…In the two cadaveric studies strength of the fixation techniques showed no great difference. 56,57 Functional outcomes cannot be accurately compared as a variety of assessment techniques were employed in the available studies. Anyways, all the techniques had good to excellent functional outcomes as assessed by various shoulder scoring systems.…”

Section: Discussionmentioning

confidence: 99%

“…56,57 In one study 56 15 cadeveric shoulders were used to create distal clavicle fractures which were fixed with 4 different techniques and the strength of each fixation was compared. Coracoclavicular suturing, distal clavicle locking plate, distal clavicle locking plate with coracoclavicular suture augmentation and hook plating are the four techniques which were employed.…”

Section: Cadaveric Studiesmentioning

confidence: 99%

Fracture of distal end clavicle: A review

Sambandam

Gupta

Kumar

et al. 2014

Journal of Clinical Orthopaedics and Trauma

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Distal end clavicleNeer type 2 a b s t r a c t Management of fracture distal end clavicle has always puzzled the orthopaedic surgeons. Now-a-days with a relatively active lifestyle, patients want better results both cosmetically and functionally. Despite so much literature available for the management of this common fracture, there is no consensus regarding the gold standard treatment for this fracture. In this article, we reviewed the literature on various techniques of management for this fracture, both conservative as well as surgical, and their merits and demerits.

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“…A recent in vitro study showed that the addition of CC suture supplementation doubled the load to failure in plate fixation of type IIB fractures. 3 This technique also avoids crossing the AC joint and eliminates the need for future removal of hardware. The described technique has been used in 5 patients with encouraging early clinical and radiographic results.…”

Section: Discussionmentioning

confidence: 99%

“…The CC augmentation aids in achieving fracture reduction while adding strength and stability to the construct. 3 …”

mentioning

confidence: 99%

Open Reduction Internal Fixation of Distal Clavicle Fracture With Supplementary Button Coracoclavicular Fixation

Hanflik

Hanypsiak

Greenspoon

et al. 2014

Arthroscopy Techniques

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Distal clavicle fractures are common, and no standard treatment exists. Many different surgical modalities exist. This report describes an open reduction internal fixation technique that achieves both plate and coracoclavicular stabilization using a button device. A precontoured superior-lateral plate is secured to the clavicle. A 3.2-mm spade-tipped drill bit is drilled across the clavicle and coracoid, passing through 4 cortices. The button is loaded onto an insertion device, passed across the 4 cortices, and captured on the undersurface of the coracoid under fluoroscopic guidance. This construct is linked to the distal clavicle plate by heavy sutures using a second button that sits in the plate. The lateral locking holes are then filled to finalize fixation. This technique provides for a simplified way to achieve coracoclavicular stabilization when using a plate for fixation of distal clavicle fractures.

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Addition of a Suture Anchor for Coracoclavicular Fixation to a Superior Locking Plate Improves Stability of Type IIB Distal Clavicle Fractures

Cited by 49 publications

References 25 publications

Coracoclavicular Ligament Suture Augmentation with Anatomical Locking Plate Fixation for Distal Clavicle Fracture

Coracoclavicular Ligament Suture Augmentation with Anatomical Locking Plate Fixation for Distal Clavicle Fracture

Fracture of distal end clavicle: A review

Open Reduction Internal Fixation of Distal Clavicle Fracture With Supplementary Button Coracoclavicular Fixation

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