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Use of plate fixation without coracoclavicular ligament augmentation for unstable distal clavicle fractures

Title
Use of plate fixation without coracoclavicular ligament augmentation for unstable distal clavicle fractures
Authors
Shin, Sang-JinKo, Young-WonLee, JuyeobPark, Min-Gyue
Ewha Authors
신상진
SCOPUS Author ID
신상진scopus
Issue Date
2016
Journal Title
JOURNAL OF SHOULDER AND ELBOW SURGERY
ISSN
1058-2746JCR Link
Citation
vol. 25, no. 6, pp. 942 - 948
Keywords
Distal clavicle fractureanatomic platecoracoclavicular ligament augmentationneer typeplate fixationcoracoclavicular distance
Publisher
MOSBY-ELSEVIER
Indexed
SCI; SCIE; SCOPUS WOS scopus
Abstract
Background: 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. Methods: 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. Results: 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 distance >10% (Constant score, 89.4 +/- 3.7; UCLA score, 32.6 +/- 3) and the patients with increased coracoclavicular distance <10% 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). Conclusion: 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. (C) 2016 Journal of Shoulder and Elbow Surgery Board of Trustees.
DOI
10.1016/j.jse.2015.10.016
Appears in Collections:
의과대학 > 의학과 > Journal papers
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