Introduction: the use of coracoclavicular augmentation systems together with locking plates in the treatment of unstable distal clavicle fractures (Neer II and Neer V) is controversial.
Material And Methods: patients with unstable distal clavicle fractures treated between 2013-2022 were retrospectively reviewed. The patients were divided into two groups: patients treated with locking plates (P group) and patients treated with locking plates and coracoclavicular augmentation systems (PCC group). Postoperative complications, modified preoperative and final coracoclavicular distance (CC), and outcomes on the Visual Analog Scale (VAS) and Quick Disabilities of the Arm, Shoulder, and Hand (Quick DASH) were recorded.
Results: 16 of 23 patients were treated with plates only, and 7 of 23 were treated with plates and coracoclavicular augmentation systems. One case showed no fracture consolidation, and there was one case of cutaneous infection. The mean final CC distance was 23.7 in the P group and 22.1 in the PCC group. The mean VAS score was 1.3 in both the P and PCC groups, while the mean Quick DASH score was 5.5 in the P group and 8.1 in the PCC group. No significant differences were found in CC distance, VAS or Quick DASH scores.
Conclusion: the use of locking plates is likely sufficient in the management of unstable distal clavicle fractures, as there were no significant differences in functional outcomes in this study when coracoclavicular augmentation systems were used together with locking plates.
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Arch Orthop Trauma Surg
January 2025
The Department of Orthopaedic Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123, Ta Pei Road, Niao Sung Dist, Kaohsiung, Taiwan.
Introduction: The optimal management strategy for unstable distal clavicular fractures remains controversial. Recent studies on plate techniques have reported good-to-excellent outcomes with no serious complications. The questions are that: (1) Does the use of wire augmentation with locking plate in distal part (distal wire augmentation) reduce radiographic loss of reduction (RLOR) and get earlier bony union in distal clavicular fractures? (2) Which fixation methods are associated with a higher incidence of acromioclavicular (AC) joints arthritis or subluxation? We collected and analyzed clinical studies on different plate fixation methods for unstable fractures to identify the best surgical modality.
View Article and Find Full Text PDFBMC Musculoskelet Disord
November 2024
Department of Orthopaedic Surgery, Ashikaga Red Cross Hospital, 284-1 Yobe-cho, Ashikaga-shi, 326-0843, Tochigi, Japan.
Background: Neer type V distal clavicle fractures are considered the most unstable fracture type and are characterized by the disruption of continuity between the coracoclavicular (C-C) ligaments and proximal or distal bone fragments. However, owing to the rarity of such fractures, there is currently no universally accepted surgical procedure for their treatment. Recently, the scorpion plate, an anatomical, non-locking, pre-contoured plate with two grasping arms to fix the distal or inferior clavicular fragments, was introduced.
View Article and Find Full Text PDFUnfallchirurgie (Heidelb)
November 2024
Department für Schulter‑, Knie- und Sportorthopädie, Klinik für Orthopädie der Medizinischen Hochschule Hannover (MHH) im DIAKOVERE Annastift, Anna-von-Borries-Str. 1-7, 30625, Hannover, Deutschland.
J Orthop Sci
June 2024
Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Iseharashi, Kanagawa 259-1143, Japan.
Background: Although various surgical methods are available for unstable distal clavicle fractures, consensus remains lacking on the optimal technique. Therefore, the present retrospective study aimed to compare the clavicle hook plate and Scorpion Plate® in terms of clinical outcomes and radiological findings for unstable distal clavicle fractures.
Methods: Fifty-seven patients with unstable distal clavicle fractures who underwent treatment using a clavicle hook plate (Group H; 28 patients) or Scorpion Plate® (Group S; 29 patients) were included in the present study.
Treatment of acute acromioclavicular (AC) joint separations is dependent on a variety of factors, including severity, acuity, patient demographics, activity level, and surgeon preferences. For more severe or unstable separations (Rockwood types IIIB, IV, V, and VI), surgical intervention is typically recommended. Over 160 surgical techniques have been described, but none have emerged as a gold standard.
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