Angular stable fixation of displaced distal-third clavicle fractures with superior precontoured locking plates

Fleming, Mark; Dachs, R; Maqungo, Sithombo; Plessis, J. P. Du; Vrettos, B; Roche, Stephen

doi:10.1016/j.jse.2014.09.024

Cited by 55 publications

(35 citation statements)

References 17 publications

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“…Plate fixation for distal clavicular fractures has been reported to achieve satisfactory bone union rates [8][9][10][11][12][13][14]; however, one of the important clinical problems is the rate of postoperative complications. While hook plates showed good outcomes for fractures with comminuted distal bone fragments, various complications, such as peri-implant fracture, dislocation, and limited range of motion were reported [6,10,15].…”

Section: Introductionmentioning

confidence: 99%

Treatment of distal clavicle fractures using a Scorpion plate and influence of timing on surgical outcomes: a retrospective cohort study of 105 cases

Furuhata

Takahashi

Hayashi

et al. 2020

BMC Musculoskelet Disord

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Background: Plate fixation is an established method for treating unstable distal clavicle fractures. However, the appropriate timing of surgery for acute distal clavicle fractures remains unclear. The present study aimed to evaluate the clinical outcomes of osteosynthesis using a Scorpion plate and to assess the influence of surgery timing on the surgical outcomes for acute unstable distal clavicle fractures. Methods: We retrospectively reviewed 105 patients who underwent fixation for acute unstable distal clavicle fractures (Neer type II and V) using the Scorpion plate between 2008 and 2018. Patients were divided into early (45 patients) and delayed (60 patients) treatment groups based on the timing of the surgical intervention (within or after 7 days). The outcomes were postoperative complications (nonunion, peri-implant fracture, plate loosening, plate-related pain, and stiffness). We evaluated the outcomes from X-ray radiographs and clinical notes. Results: Among the 105 patients, nonunion, plate loosening, plate-related pain, and stiffness were observed in six patients (5.7%), four patients (3.8%), seven patients (6.7%), and one patient (1.0%), respectively. The nonunion rate was significantly higher in the delayed treatment group than that in the early treatment group (P = 0.036). Although the difference was not significant, plate loosening and stiffness were only observed in the delayed treatment group. Conclusion: Our results demonstrated that osteosynthesis using Scorpion plates achieved satisfactory surgical outcomes for unstable distal clavicle fractures. In addition, this study suggested that performing surgery within 6 days after injury is recommended to reduce postoperative complications.

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Section: Introductionmentioning

confidence: 99%

Treatment of distal clavicle fractures using a Scorpion plate and influence of timing on surgical outcomes: a retrospective cohort study of 105 cases

Furuhata

Takahashi

Hayashi

et al. 2020

BMC Musculoskelet Disord

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“…Some authors reported successful clinical results using this methods. 20,21) In this method, early mobilization is possible, thereby reducing the risk of joint stiffness. Additionally, stable fixation can be achieved without involving the subacromial space or AC joint that can lead to AC joint arthritis and rotator cuff injury.…”

Section: Discussionmentioning

confidence: 99%

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

Nam

Moon²,

Choi

2017

Clin Shoulder Elbow

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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.

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“…These three plates were selected because they were clinically available and the authors were familiar with the use of these plates in their institution. Moreover, distal clavicle plate and LCP clavicle plate are widely used worldwide [9,10]. The number of locking screws on the lateral end varied according to the products, and each plate had its own orientation of locking screws.…”

Section: Locking Plate Model and Simulationmentioning

confidence: 99%

Comparing Locking Screw Direction Among Three Locking Plates for Lateral Clavicle Fractures: A Simulation Study

Abe

Koizumi

Shimada

et al. 2020

Preprint

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BackgroundThe current study aimed to measure screw angles of three locking plates for lateral clavicle fractures and to assess the numbers of screws that could be inserted per fragment size to elucidate the size limitation that could be fixed by locking plates.MethodsThe authors assessed three locking plates for lateral clavicle fractures: distal clavicle plate [Acumed, LLC, Oregon, the USA], LCP clavicle plate lateral extension [Depuy Synthes, LLC, MA, the USA], and HAI clavicle plate [HOMS Engineering, Inc., Nagano, Japan]. Using three-dimensional plate models, the angles between the most medial and lateral locking screws on the coronal plane and between the most anterior and posterior locking screws on the sagittal plane were measured. Two examiners independently performed computer simulation to position the plates as laterally as possible in the ten normal three-dimensional clavicle models. A lateral fragment size of 10, 15, 20, 25, and 30 mm was simulated in the acromioclavicular joint and the number of screws completely inserted in each size of the fragment in the simulation was assessed. Subsequently, the area covered by locking screws on the inferior surface of the clavicle was measured.ResultsThe distal clavicle plate had relatively large screw angles (20° on the coronal plane and 32° on the sagittal plane), and the LCP clavicle lateral extension had a large angle (38°) on the sagittal plane. However, the angle of the HAI clavicle plate was at maximum 13° on the coronal or sagittal plane. The distal clavicle plate indicated the largest numbers of screws that could be inserted in each size of the bone fragment. For all locking plates, all screws could be inserted within 25 mm fragments. Among all locking plates, the distal clavicle plate could cover the largest area on the inferior surface of the clavicle by the screws.ConclusionsScrew angles and the numbers of screws that could be inserted in the lateral fragment differed among products. Other augmented fixation procedures should be considered for fractures with fragment sizes <25 mm that could not be fixed with sufficient number of screws.

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Angular stable fixation of displaced distal-third clavicle fractures with superior precontoured locking plates

Cited by 55 publications

References 17 publications

Treatment of distal clavicle fractures using a Scorpion plate and influence of timing on surgical outcomes: a retrospective cohort study of 105 cases

Treatment of distal clavicle fractures using a Scorpion plate and influence of timing on surgical outcomes: a retrospective cohort study of 105 cases

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

Comparing Locking Screw Direction Among Three Locking Plates for Lateral Clavicle Fractures: A Simulation Study

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