J Korean Fract Soc.  2011 Jan;24(1):41-47. 10.12671/jkfs.2011.24.1.41.

The Surgical Outcomes of Clavicle Lateral End Fractures Fixed with the Oblique T Locking Compession Plate

• Nam SO
• Byun YS
• Shin DJ
• Shin JH
• Lee CY
• Kim TG

• KMID: 1449415
• DOI: http://doi.org/10.12671/jkfs.2011.24.1.41

Abstract

PURPOSE
The purpose of this study is to evaluate the surgical outcomes of the clavicle lateral end fracture fixed with an oblique T locking compression plate (LCP).
MATERIALS AND METHODS
Fourteen clavicle lateral end fractures were fixed with the oblique T-LCP and followed up for at least 1 year after the surgery. Thirteen cases were unstable Neer type II fractures and one case was nonunion of the Neer type I fracture. The mean age was 46 years of age (range, 26~70). In ten cases, augmenting sutures with the absorbable suture material were placed in the coraco-clavicular ligament and around the plate and the clavicle to improve the stability of fracture fixation. Autogenous iliac bone graft was done in four cases. The clinical outcomes were evaluated by using UCLA scoring system and KSS (Korean Shoulder Score).
RESULTS
The mean UCLA score was 33.5 and the mean KSS was 94.9. Average time of bone union was 11.9 weeks (range, 6~28), including 1 case with a delayed union. There was no complication such as loss of fixation or nonunion.
CONCLUSION
Fixation with the oblique T-LCP is a good option providing reliable functional results in clavicle lateral end fractures.

Keyword

Clavicle; Lateral end fracture; Oblique T locking compression plate

MeSH Terms

Clavicle
Fracture Fixation
Ligaments
Shoulder
Sutures
Transplants

Figure

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  Fig. 1 (A~C) Oblique T Locking Compression Plate is appropriate for fixation of clavicle lateral end fracture.

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  Fig. 2 Intraoperative photographs. (A) Patient was placed Beach chair position. (B) The direct approach with Langer's line was used for exposure. (C) Acromio-clavicular joint was marked with a needle (circle). (D) The Needle of acromio-clavicular joint was seen on fluoroscopic view (circle). (E, F) The Needle makes plate positioning easy. Plate was fixed with screws. (G, H) After screw fixation, unstable fragment that coraco-clavicular ligament was attached was coiled with absorbable suture material through coraco-clavicular ligament.

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  Fig. 3 A 47-year-old man sustained a clavicle lateral end fracture by a traffic accident. (A, B) Preoperative radiographs show Neer type II, Craig type V unstable clavicle lateral end fracture. (C, D) Satisfactory reduction and fixation was seen on postoperative radiographs. (E, F) Radiographs 4 weeks after operation show bone absorption. (G, H) Final radiographs 57 weeks after operation show solid union without implant loosening and loss of reduction.

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  Fig. 4 A 39-year-old man sustained a clavicle lateral end fracture by a traffic accident. (A~C) Reconstructed three-dimensional CT scans show a comminuted, unstable fracture of clavicle lateral end. (D, E) Preoperative radiographs show Neer type II, Craig type V clavicle lateral end fracture (F, G) Final radiographs 2 years after operation show solid union without implant loosening and loss of reduction. (H~L) The photographs show a good functional result with full forward flexion and internal and external rotation of shoulders at final follow-up (postoperative 2 years).

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