Abstract:Medial clavicle fractures are the least common type of clavicular fractures. Although rare, such injuries deserve rapid diagnosis and effective treatment to avoid future complications. An optimal, standardized operative treatment has not been yet established. We report a case of medial clavicle fracture, where primary operative treatment was indicated due to gross dislocation. An open reduction and osteosynthesis with a modified hook plate was performed, leading to an excellent postoperative outcome after a si… Show more
“…This plate complementary maintains reduction of anterior-posterior dislocation and acromioclavicular joint width and can be used for the treatment of acromioclavicular luxation and fractures of the lateral clavicle [15]. In some cases this device also has been used for sternoclavicular joint dislocations [16]. After modification of the plate in 2005 it is also available with locked screws, which gives extra stability for the treatment of fractures of the lateral clavicle and makes minimal invasive application of the plate with the use of only two screws possible.…”
Acromioclavicular joint dislocations often occur in athletic, young patients after blunt force to the shoulder. Several static and dynamic operative procedures with or without primary ligament replacement have been described. Between February 2003 and March 2009 we treated 313 patients suffering from Rockwood III-V lesions of the AC joint with an AC-hook plate. 225 (72%) of these patients could be followed up. Mean operation time was 42 minutes in the conventional group and 47 minutes in the minimal invasive group. The postoperative pain on a scale from 1 to 10 (VAS-scale) was rated 2.7 in the conventional group and 2.2 in the minimal invasive group. Taft score showed very good and good results in 189 patients (84%). Constant score showed an average of 92.4 of 100 possible points with 89% excellent and good results and 11% satisfying results. All patients had some degree of pain or discomfort with the hookplate in place. These symptoms were relieved after removal of the plate. The overall complication rate was 10.6%. There were 6 superficial soft tissue infections, 1 fracture of the acromion, 7 redislocations after removal of the hook-plate. We observed 4 broken hooks which could be removed at the time of plate removal, 4 seromas and 2 cases of lateral clavicle bone infection, which required early removal of the plate. We can conclude that clavicle hook plate is a convenient device for the surgical treatment of Rockwood Grade III-V dislocations, giving good mid-term results with a low overall complication rate compared to the literature. Early functional therapy is possible and can avoid limitations in postoperative shoulder function.
“…This plate complementary maintains reduction of anterior-posterior dislocation and acromioclavicular joint width and can be used for the treatment of acromioclavicular luxation and fractures of the lateral clavicle [15]. In some cases this device also has been used for sternoclavicular joint dislocations [16]. After modification of the plate in 2005 it is also available with locked screws, which gives extra stability for the treatment of fractures of the lateral clavicle and makes minimal invasive application of the plate with the use of only two screws possible.…”
Acromioclavicular joint dislocations often occur in athletic, young patients after blunt force to the shoulder. Several static and dynamic operative procedures with or without primary ligament replacement have been described. Between February 2003 and March 2009 we treated 313 patients suffering from Rockwood III-V lesions of the AC joint with an AC-hook plate. 225 (72%) of these patients could be followed up. Mean operation time was 42 minutes in the conventional group and 47 minutes in the minimal invasive group. The postoperative pain on a scale from 1 to 10 (VAS-scale) was rated 2.7 in the conventional group and 2.2 in the minimal invasive group. Taft score showed very good and good results in 189 patients (84%). Constant score showed an average of 92.4 of 100 possible points with 89% excellent and good results and 11% satisfying results. All patients had some degree of pain or discomfort with the hookplate in place. These symptoms were relieved after removal of the plate. The overall complication rate was 10.6%. There were 6 superficial soft tissue infections, 1 fracture of the acromion, 7 redislocations after removal of the hook-plate. We observed 4 broken hooks which could be removed at the time of plate removal, 4 seromas and 2 cases of lateral clavicle bone infection, which required early removal of the plate. We can conclude that clavicle hook plate is a convenient device for the surgical treatment of Rockwood Grade III-V dislocations, giving good mid-term results with a low overall complication rate compared to the literature. Early functional therapy is possible and can avoid limitations in postoperative shoulder function.
“…Gill et al [6] reported using a modified hook plate for a medial clavicle fracture in a 21-year-old female. Although clinical results were satisfactory, the plate crossed the SC joint, where high bending forces occur during shoulder motion.…”
Fractures of the medial clavicle are rare injuries. Recently, open reduction and internal fixation has been recommended for displaced medial clavicle fractures in order to prevent non-union and dysfunction. Because of the rarity of this injury, the optimal fixation device has not yet been established. In this report, we describe a case of a 40-year-old male patient who sustained a significantly displaced medial clavicle fracture treated by open reduction and internal fixation using an inverted distal clavicle anatomic locking plate. At the 12 months follow-up, the patient recovered well, had returned to pre-injury job, and was quite satisfied with the outcome. Internal fixation of medial clavicle fracture using an inverted distal clavicle anatomic locking plate of the ipsilateral side appears to be a good treatment option.
“…However, there is not a commonly accepted surgical fixation method. Pins, wires, small fragment reconstruction plates, dynamic compression and hook plates and plates manufactured specially for this anatomical site are all used [10,[20][21]. Plate screw fixation seems to be safer than pin or wire fixation [22].…”
Medial clavicle fractures are not common and may be associated with injuries to the adjacent vital structures. This study consists of the case of a 15-year-old boy who had a preexistingventriculoperitoneal shunt and a displaced medial clavicle fracture. In the study, we performed a successful surgical treatment using a distal radius locking plate. The mechanism of the injury and treatment options are discussed in relation to the literature in the field.
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