Use of plate fixation without coracoclavicular ligament augmentation for unstable distal clavicle fractures
| Autor: | Young Won Ko, Min Gyue Park, Sang Jin Shin, Juyeob Lee |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Distal clavicle Fracture Fixation Internal Fractures Bone 03 medical and health sciences 0302 clinical medicine medicine Humans Orthopedics and Sports Medicine Prospective Studies Aged Plate fixation Coracoclavicular ligament Fracture Healing 030222 orthopedics Bone union business.industry Level iv 030229 sport sciences General Medicine Middle Aged Ucla score Clavicle Surgery Radiography Treatment Outcome medicine.anatomical_structure Ligaments Articular Female Constant score Plain radiographs business Bone Plates |
| Zdroj: | Journal of Shoulder and Elbow Surgery. 25:942-948 |
| ISSN: | 1058-2746 |
| DOI: | 10.1016/j.jse.2015.10.016 |
| Popis: | The purpose of this study was to evaluate the clinical and radiologic outcomes of unstable distal clavicle fractures treated with anatomic plate fixation without coracoclavicular ligament augmentation and to compare the outcome of Neer type IIA with that of type IIB.Twenty-five patients with unstable distal clavicle fractures who underwent anatomic plate fixation without coracoclavicular ligament augmentation were enrolled prospectively, including 9 patients of Neer type IIA and 16 patients of Neer type IIB. Clinical outcomes were evaluated using Constant and University of California-Los Angeles (UCLA) scores. Coracoclavicular distance was measured on plain radiographs.Bone union was achieved in all patients. Satisfactory clinical and radiologic outcomes were obtained regardless of fracture type. After operation, the mean coracoclavicular distance on the injured side was increased by 10% compared with the uninjured side. However, between the patients who showed an increased coracoclavicular distance10% (Constant score, 89.4 ± 3.7; UCLA score, 32.6 ± 3) and the patients with increased coracoclavicular distance10% of the uninjured side (Constant score, 88.7 ± 3.6; UCLA score, 31.9 ± 3), there was no statistically significant difference in clinical outcomes of Constant score (P = .934) and UCLA score (P = .598).In unstable distal clavicle fractures, precontoured anatomic plate fixation without coracoclavicular ligament augmentation showed satisfactory clinical outcomes and high union rates even with a small lateral fragment. Patients who had increased coracoclavicular distance also demonstrated satisfactory shoulder functional outcomes regardless of the fracture type. Therefore, anatomic plate fixation without additional coracoclavicular ligament augmentation can be considered one of the treatment options for unstable distal clavicle fracture.Level IV; Case Series; Treatment Study. |
| Databáze: | OpenAIRE |
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