J Korean Fract Soc.  2009 Jan;22(1):24-29. 10.12671/jkfs.2009.22.1.24.

Double Tension Band Wire Fixation for Unstable Fracture of the Distal Clavicle

• Song KS
• Kim HG
• Park BM
• Kim JM
• Jung SH
• Yang BS

• KMID: 2183884
• DOI: http://doi.org/10.12671/jkfs.2009.22.1.24

Abstract

PURPOSE
To evaluate the clinical results after operative treatment with the double tension band wire fixation in Neer type II and III distal clavicle fractures.
MATERIALS AND METHODS
Ten patients with type II and III distal clavicle fractures were evaluated, who operated with double tension band wire fixation technique, from Febrary 2007 to June 2008, and could be followed-up for more than 1 year after operation. Postoperative assessments were evaluated on plain x-ray, pain, and clinical finding according to the functional criteria by Kona et al.
RESULTS
Average duration from operation to fracture union was 8 weeks in all cases. There were 8 excellent and 2 good results. It was no other significant complications such as K-wire migration, breakage, infection, and AC joint arthritis.
CONCLUSION
Double tension band wire fixation technique seems to be an effective method for type II or III distal clavicle fracture with multiple compressive axis, without injury of the AC joint and loosening of the fixation.

Keyword

Distal clavicle fracture; Double tension band wire fixation

MeSH Terms

Axis, Cervical Vertebra
Clavicle
Humans
Joints

Figure

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  Fig. 1 Illustrations of the surgical technique of double tension band wire fixation for distal clavicle. (A) Insertion two K-wires from distal to proximal and one K-wire from anteior to posterior for typical tension band wire fixation. (B) Insertion of one more K-wire from anterior to posterior at distal fragment and another tension band wire fixation over the fracture site.

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  Fig. 2 A demonstration model of the double tension band wire fixation.

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  Fig. 3 A 32-years-old male was injured by traffic accident. (A) The radiograph shows a type IIb unstable distal clavicle fracture with a long transverse fragment. (B) The fracture is fixed with double tension band wire and additional two circular wires. (C) After removal of the implats at postoperative 14 months, complete union of the fracture site is seen.

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  Fig. 4 A 17-years-old female was injured by slip down. (A) The radiograph shows a type IIb unstable distal clavicle fracture. (B) Postoperative radiograph shows the fracture fixed with double tension band wire. (C) Fracture is united in 6 weeks after surgery on radiograph.

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