Coracoclavicular Screw Fixation for Unstable Distal Clavicle Fractures

Macheras, George A.; Kateros, Konstantinos; Savvidou, Olga D.; Sofianos, John; Fawzy, Ernest; Papagelopoulos, Panayiotis J.

doi:10.3928/0147-7447-20050701-18

Cited by 62 publications

(26 citation statements)

References 15 publications

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“…[2][3][4][5][6] As a result, surgical treatment has been recommended for Neer type II fractures. 7,8 Many surgical procedures have been developed for treatment of Neer type II distal clavicle fractures, including transacromial Kirschner wires and Knowles pins, 3,9 the Weaver-Dunn procedure, 10 tension band wires, 11,12 coracoclavicular screw fixation, 13,14 plate fixation, [15][16][17][18] and arthroscopic treatment. [19][20][21] None of these is generally regarded as the gold standard treatment.…”

Section: Clinical Results Of Treatment Using a Clavicular Hook Plate mentioning

confidence: 99%

Clinical Results of Treatment Using a Clavicular Hook Plate Versus a T-plate in Neer Type II Distal Clavicle Fractures

Tan¹,

Zhao²,

Chen³

et al. 2012

Orthopedics

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AO clavicular hook plate fixation provides more rigid fixation and good bony union rates for Neer type II distal clavicular fractures. However, the hook may cause rotator cuff tears and subacromial impingement, which adversely affect the clinical results. T-plate fixation is another surgical method of treatment for unstable clavicle fractures, and its clinical efficacy has been demonstrated. The purpose of this study was to compare the clinical outcomes of AO clavicular hook plate and T-plate fixation for Neer type II distal clavicular fractures. Forty-two patients with Neer type II fractures were divided into 2 groups. The hook plate group comprised 23 patients who underwent hook plate fixation, and the T-plate group comprised 19 patients who underwent distal radius volar locking T-plate fixation. Hook plates were removed 3 to 14 months postoperatively in 15 patients because of shoulder function limitations. All patients were evaluated postoperatively for shoulder pain, activities of daily living, range of motion, strength, and satisfaction according to the University of California, Los Angeles (UCLA) Shoulder rating scale. All fractures in the 2 groups achieved stable fixation and bony union. Both groups yielded similar outcomes with regard to shoulder strength and patient satisfaction (P5.207 and P5.398, respectively). Significant differences existed between the 2 groups in the mean scores of shoulder pain, activities of daily living, range of motion, and total UCLA score (P5.001, P5.011, P5.038, and P5.001, respectively). More patients (74%) in the hook plate group had mild to severe shoulder pain than in the T-plate group (16%). However, shoulder pain was relieved and function improved significantly after removal of the hook plate (P5.001).

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Section: Clinical Results Of Treatment Using a Clavicular Hook Plate mentioning

confidence: 99%

Clinical Results of Treatment Using a Clavicular Hook Plate Versus a T-plate in Neer Type II Distal Clavicle Fractures

Tan¹,

Zhao²,

Chen³

et al. 2012

Orthopedics

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“…1,11,12 Because reconstruction of an established nonunion may be technically challenging, operation is frequently recommended as a primary treatment. 7 A wide variety of operative techniques have been described to treat these injuries, the most popular of which are coracoclavicular screws 13,14 and hook plates, [15][16][17] and more recently, tailor-made lateral clavicular plates. Although primary operative treatment may reduce the risk of subsequent nonunion it carries its own complications, including hardware failure and infection.…”

mentioning

confidence: 99%

Open reduction and endobutton fixation of displaced fractures of the lateral end of the clavicle in younger patients

Robinson

Akhtar

Jenkins

et al. 2010

The Journal of Bone and Joint Surgery. British volume

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Displaced fractures of the lateral end of the clavicle in young patients have a high incidence of nonunion and a poor functional outcome after conservative management. Operative treatment is therefore usually recommended. However, current techniques may be associated with complications which require removal of the fixation device. We have evaluated the functional and radiological outcomes using a novel technique of open reduction and internal fixation. A series of 16 patients under 60 years of age with displaced fractures of the lateral end were treated by open reduction and fixation using a twin coracoclavicular endobutton technique. They were followed up for the first year after their injury. At one year the mean Constant score was 87.1 and the median Disabilities of the Arm, Shoulder and Hand score was 3.3. All fractures had united, except in one patient who developed an asymptomatic fibrous union. One patient had post-traumatic stiffness of the shoulder, which resolved with physiotherapy. None required re-operation. This technique produces good functional and radiological outcomes with a low prevalence of complications and routine implant removal is not necessary.

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“…Several surgical treatment methods have been reported for type II distal clavicle fracture. 3,[5][6][7][8][9][10][11][12] if the distal fragment is too small to achieve stable fixation, surgical methods focus on rigid fixation of the distal fragment or CC interval.…”

Section: Discussionmentioning

confidence: 99%

“…These methods include the use of CC screws, ten-sion bands, K-wire fixation, hook plates and locking plates. 3,[5][6][7][8][9][10][11][12] However, these methods have risks for complications, such as pin migration, acromioclavicular (AC) joint degeneration, loss of reduction, and subacromial impingement. 13) In addition, type II fractures have a relatively small sized distal fragment which is insufficient to achieve stable fixation using a single method.…”

Section: Introductionmentioning

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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Coracoclavicular Screw Fixation for Unstable Distal Clavicle Fractures

Cited by 62 publications

References 15 publications

Clinical Results of Treatment Using a Clavicular Hook Plate Versus a T-plate in Neer Type II Distal Clavicle Fractures

Clinical Results of Treatment Using a Clavicular Hook Plate Versus a T-plate in Neer Type II Distal Clavicle Fractures

Open reduction and endobutton fixation of displaced fractures of the lateral end of the clavicle in younger patients

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

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