Modified tension band fixation and coracoclavicular stabilisation for unstable distal clavicle fracture

Choi, Sung Wook; Kim, Sang-Rim; Kang, Hyunseong; Kim, Dong‐Hee; Park, Yong Bum

doi:10.1016/j.injury.2014.09.025

Cited by 24 publications

(16 citation statements)

References 19 publications

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“…Eighteen patients experienced a complete functional recovery with normal range of motion and pain relief. Two patients had prolonged physical therapy due Journal of Orthopaedic Surgery 25 (1) to limited range of motion at shoulder joint, who achieved normal range of motion at the end of year 1. Two patients were not able to return to work because of weakness and persistent shoulder pain with no difficulty in performing daily activities.…”

Section: Resultsmentioning

confidence: 99%

“…The tunnel was used to deliver double button lift-up system by a 3.5-mm carrier guidewire. After ensuring that the button was emerged inferior to the coracoid as Journal of Orthopaedic Surgery 25 (1) confirmed by the fluoroscope, it was rolled over and locked under the coracoid process ( Figure 4). After temporary reduction with the help of manual pressure on the medial clavicle, lift-up system was tightened by pushing the extremity and shoulder superiorly, followed by tightening of the rope passing through the second button over the clavicle, ensuring a reduction without separation of fracture line.…”

Section: Surgical Techniquementioning

confidence: 99%

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Results of minimal invasive coracoclavicular fixation by double button lift-up system in Neer type II distal clavicle fractures

Dedeoğlu

İmren

Çabuk

et al. 2017

J Orthop Surg (Hong Kong)

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Aim: We aimed to evaluate clinical and functional outcomes of indirect fracture reduction performed by coracoclavicular fixation with minimal invasive double button lift-up system in Neer type IIa unstable fractures of distal clavicle. Material and methods: 22 patients with Neer type 2 distal clavicle fracture were enrolled in that prospective study. All patients underwent indirect reduction and osteosynthesis performed by coracoclavicular fixation with minimal invasive double button lift-up system. Postoperative follow-up was carried out clinically and radiologically with plain X-rays and utilization of Constant and American Shoulder and Elbow Surgeons Standardized Shoulder Assessment (ASES) shoulder scores. Mean follow-up time was 15 months. A standard sling was applied for 2 weeks, postoperatively. Rehabilitation program was started on postoperative day 1. Results: Mean age was 39 (range: 21-60), 18 of the patients were male. Right dominant extremity was affected in 14 patients. Mean duration of the surgical intervention was 40 min (range: 30-55 min). Mean union time was found to be 14 weeks (range: 7-21 weeks). Mean postoperative ASES and Constant scores were 79.9 (66.9-88.3) and 82.2 (71-100), respectively. The duration of return to normal daily activities were found to be 4.5 months. Any loss of reduction, AC joint arthrosis, and clavicular shortening were not detected in X-rays. Conclusion: This study has demonstrated that indirect osteosynthesis performed by coracoclavicular fixation with double button lift-up system in the treatment of unstable Neer type IIa fractures of the distal clavicle had successful clinical, radiological, and functional outcomes.

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Section: Resultsmentioning

confidence: 99%

Section: Surgical Techniquementioning

confidence: 99%

Results of minimal invasive coracoclavicular fixation by double button lift-up system in Neer type II distal clavicle fractures

Dedeoğlu

İmren

Çabuk

et al. 2017

J Orthop Surg (Hong Kong)

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“…Most of these techniques have their disadvantages and could lead to certain complications, such as fixation failure, metal breakage, migration, secondary clavicle or coracoid fracture, acromial erosion, impingement, or rotator cuff injury, etc. [8][9][10][11]17] Stegeman et al [18] even recommended avoiding using hook plate due to the high rate and severity of the complications, according to a meta-analysis. Moreover, second operations for implant removal are usually needed.…”

Section: Discussionmentioning

confidence: 99%

“…The fracture mechanism of a Neer type Ⅱb distal clavicle fracture is considered the same as AC joint dislocation (Rockwood classification type-Ⅲ or higher). Therefore, it is important to perform CC ligament stabilization for the treatment of unstable distal clavicle fracture, and current surgical techniques have focused more on this [17,[19][20][21] . These studies aimed to provide anatomic augmentation of the CC ligaments using open or arthroscopic approaches.…”

Section: Discussionmentioning

confidence: 99%

“…Although Choi S et al [17] reported high union rate and good functional outcome in the treatment of Kanchanatawan W et al [28] whereby 100% of distal clavicle fracture cases displayed clinical union and good to excellent shoulder function, who were treated by a modified coracoclavicular stabilization technique using a bidirectional coracoclavicular loop system. This may be related to the advantages of CC ligament stabilization.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of the modified CC stabilization using LARS artificial ligament in unstable distal clavicle fracture

Shen

et al. 2020

Preprint

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Purpose: Unstable distal clavicle fracture is common, and there is no consensus regarding the gold standard treatment for this fracture. The purpose of this study was to report a new surgical technique for the treatment of unstable distal clavicle fracture with modified coracoclavicular (CC) stabilization using ligament augmentation and reconstruction system (LARS) artificial ligament, and evaluate the clinical and radiographic outcomes. Methods: From January 2009 to June 2018, eighteen patients with acute unstable distal clavicle fractures (type Ⅱb) treated by modified CC stabilization using LARS artificial ligament were retrospectively reviewed. Indexes for evaluation included fracture healing, quality of reduction, and complications (infections, nerve injuries, iatrogenic clavicle or coracoid fracture, the fixation loop failure, loss of reduction, etc.). Shoulder function was evaluated using the Constant-Murley score. Results: The patients were assessed at a mean time of 31.8 months follow-up. All 18 patients experienced radiographic union. Follow-up radiographs showed anatomical reduction in 15 patients and slight loss of reduction in 3 patients. There were 2 cases of calcification of CC ligament, 1 case of degenerative change around the acromioclavicular (AC) joint, and 1 case of clavicular osteolysis around screws noted during the follow-up. The Constant scores were 91.2 ± 6.9 at last. Conclusions: The modified CC stabilization using LARS artificial ligament resulted in a high union rate, satisfactory fracture reduction, a low complication rate, and excellent shoulder function for unstable distal clavicle fractures (type Ⅱb). We consider this simple surgical technique that naturally restores stability to the distal clavicle fracture is an efficient method for treating the fracture.

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Management of acute unstable distal clavicle fracture with a modified coracoclavicular stabilization technique using a bidirectional coracoclavicular loop system

Kanchanatawan

Wongthongsalee

2015

Eur J Orthop Surg Traumatol

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Modified CC stabilization using bidirectional CC loops seated behind the CA ligament is a simple surgical technique that naturally restores stability to the distal clavicle fracture. It also produces predictable outcomes, a high union rate, good to excellent shoulder function, and a low complication rate. The buttons and suture loops were routinely removed in a second operation in order to prevent late stress fracture of the clavicle.

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Modified tension band fixation and coracoclavicular stabilisation for unstable distal clavicle fracture

Cited by 24 publications

References 19 publications

Results of minimal invasive coracoclavicular fixation by double button lift-up system in Neer type II distal clavicle fractures

Results of minimal invasive coracoclavicular fixation by double button lift-up system in Neer type II distal clavicle fractures

Evaluation of the modified CC stabilization using LARS artificial ligament in unstable distal clavicle fracture

Management of acute unstable distal clavicle fracture with a modified coracoclavicular stabilization technique using a bidirectional coracoclavicular loop system

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