All arthroscopic coracoclavicular button fixation is efficient for Neer type II distal clavicle fractures

Kapıcıoğlu, Mehmet; Erden, Tunay; Bilgin, Emre; Bilsel, Kerem

doi:10.1007/s00167-020-06048-8

Cited by 20 publications

(25 citation statements)

References 25 publications

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“…2,13 However, this technique bears the risk of coracoid fractures or button migration and consecutive loss of reduction. 3,5 In addition, up to 29% of patients report local irritation by prominent implants, or suture material sometimes also requiring secondary surgerydeven with arthroscopic techniques. 17,20 It appears that a solid, reproducible fixation method for this fracture entity has not yet been found.…”

mentioning

confidence: 99%

Stand-alone coracoclavicular suture repair achieves very good results in unstable distal clavicle fractures at a minimum follow-up of 1 year

Laux¹,

Villefort²,

Nashar³

et al. 2021

Journal of Shoulder and Elbow Surgery

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Background: The treatment of unstable (Neer type IIB and V) extra-articular distal clavicle fractures remains challenging, especially when encountering a small lateral fragment which does not allow for sufficient screw purchase. It was the purpose of this study to present the clinical and radiologic outcome of a consecutive series of patients treated by a stand-alone coracoclavicular stabilization using a so-called cow-hitch technique with a suture anchor. Methods: Nineteen patients were treated with a specific surgical technique for distal clavicle fractures (11 left, 8 right) with either rupture or bony avulsion of the coracoclavicular ligaments. Fourteen patients were examined in our outpatient clinic for the purpose of this study after a mean follow-up of 5 years (1-12.2 years). The examination included scoring according to Constant Murley score (CMS), the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES), the Subjective Shoulder Value (SSV), and follow-up radiographs. Two additional patients were amenable to a telephone interview. Results: All patients reported very good subjective results, with a mean SSV of 92% and a mean ASES score of 96%. The CMS resulted in average absolute values of 92 points. Fractures consolidated in 95% of cases. One patient developed an asymptomatic pseudarthrosis. The coracoclavicular distance was restored from 21 mm preoperatively to 11 mm at the final follow-up and finally showed an average side-to-side difference of þ1.8 mm. Sports activities were fully resumed after an average of 4.7 months. Conclusion:The coracoclavicular stand-alone cow-hitch suture repair for unstable distal clavicle fractures is a minimally invasive fixation technique without prominent hardware that allows for an anatomic reduction and stable fixation with a low complication and high bony union rate. Both radiographic and clinical long-term results are very satisfactory.

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confidence: 99%

Stand-alone coracoclavicular suture repair achieves very good results in unstable distal clavicle fractures at a minimum follow-up of 1 year

Laux¹,

Villefort²,

Nashar³

et al. 2021

Journal of Shoulder and Elbow Surgery

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“…As one of the latest recommended surgical treatments, arthroscopically assisted coracoclavicular fixation may improve functional outcomes and lower complication rates. 25 There is no need for secondary surgery to remove the implanted device after fracture union; this is regarded as a prominent advantage of arthroscopically assisted coracoclavicular fixation over hook plate fixation. However, Ding et al.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for clavicular midshaft fractures after hook plate fixation for the treatment of Neer type II clavicular fractures

Tian

Leng

et al. 2021

J Int Med Res

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Objective Neer type II fractures are common, and hook plate fixation is one of the recommended treatments. Although clavicular midshaft fractures after hook plate fixation are rare, such fractures increase patients’ suffering and worsen their functional outcomes. This study was performed to identify the risk factors for this complication. Methods From 2009 to 2018, 425 patients were admitted with Neer type II clavicular fractures. According to the selection criteria, 352 patients were included in this retrospective observational study. All patients were divided into either the complications group (patients with midshaft fractures) or the control group (patients without midshaft fractures). Data collected included patient demographics and surgical, hook plate, and screw characteristics. The chi-square test was used to conduct between-group comparisons of risk factors. Statistically significant variables were included in a logistic regression model. Results In both the complications group (n = 21) and control group (n = 331), significantly more patients of advanced age and significantly more patients treated with hook plates that were not bent during surgery developed midshaft fractures. Conclusion The risk of a clavicular midshaft fracture after hook plate fixation may be significantly increased by advanced age or a lack of hook plate bending.

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“…Hook plates, conventional plates, Kirschner wires (K-wires), a single cortical screw, anatomic locking plates (LPs), and arthroscopic-assisted coracoclavicular button (CB) systems have been used for the surgical treatment of distal clavicle fractures. 3 , 6 , 7 , 11 , 15 , 16 , 18 , 20 , 23 , 24 …”

mentioning

confidence: 99%

“…All arthroscopic CB fixation systems were developed for acromioclavicular dislocations and are used for fixation of distal clavicle fractures, and successful results have been reported. 7 , 16 The potential advantages of the technique are minimal invasiveness, no need for implant removal, and avoidance of disruption of the delicate subacromial space. 5 , 7 However, arthroscopic surgery requires surgeon experience and training.…”

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confidence: 99%

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Arthroscopic coracoclavicular button fixation versus anatomic locking plate fixation for unstable distal clavicular fractures

Erden¹,

Kapıcıoğlu²,

Erşen³

et al. 2021

JSES International

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Hypothesis Neer type II distal clavicle fractures are unstable and associated with high nonunion rates. The aim of this retrospective study was to compare the clinical and radiographic outcomes of anatomic locking plate fixation and arthroscopic coracoclavicular button fixation for unstable distal clavicle fractures. Methods Forty-seven patients with Neer type II distal clavicle fractures were treated surgically using either anatomic locking plate fixation (group 1, n = 20) or all arthroscopic coracoclavicular button fixation (group 2, n = 27) between 2012 and 2019 in 2 centers. Clinical and radiographic outcomes after an average follow-up period of 49 months for group 1 and 32 months for group 2 were assessed using the American Shoulder and Elbow Surgeons Shoulder score, Constant-Murley score, visual analog scale score and X-rays. Results At the final follow-up, the mean American Shoulder and Elbow Surgeons Shoulder score, Constant-Murley score, and visual analog scale score for group 1 and group 2 were 92.5 ± 3.9 (range 88.3-98.3), 93.6 ± 4.0 (range 90-100), and 0.6 ± 0.6 (range 0-2) and 95 ± 3.3 (range 86.6-100), 96.2 ± 3.0 (range 88-100), and 0.4 ± 0.5 (range 0-1), respectively ( P = .32, P = .15, and P = .59, respectively). At the final follow-up, acceptable reduction and bone healing were achieved in all patients. All patients in both groups were able to resume work as well as sports activities. Postoperative complications included 1 case of acromioclavicular joint arthritis and 1 case of screw penetration in group 1 and 2 cases of coracoid process fracture that did not require additional surgery in group 2. Five patients underwent hardware removal owing to skin irritation and dissatisfaction with the cosmetic appearance in group 1. Conclusion Both distal anatomic locking plate fixation and arthroscopic coracoclavicular button fixation provide satisfactory functional and radiological outcomes. Both procedures can be used to treat distal clavicle fractures because they have a minimal risk of complications and present similar, high union rates.

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All arthroscopic coracoclavicular button fixation is efficient for Neer type II distal clavicle fractures

Cited by 20 publications

References 25 publications

Stand-alone coracoclavicular suture repair achieves very good results in unstable distal clavicle fractures at a minimum follow-up of 1 year

Stand-alone coracoclavicular suture repair achieves very good results in unstable distal clavicle fractures at a minimum follow-up of 1 year

Risk factors for clavicular midshaft fractures after hook plate fixation for the treatment of Neer type II clavicular fractures

Arthroscopic coracoclavicular button fixation versus anatomic locking plate fixation for unstable distal clavicular fractures

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