J Korean Fract Soc.
2001 Oct;14(4):706-713.
The Surgical Treatment of Distal Clavicle Fractures
Abstract
- PURPOSE
To evaluate and analyze the clinical and radiological result of surgical treatment for distal clavicular fractures.
MATERIALS AND METHODS
From Jan. 1995 to May. 2000, eighteen cases of distal clavicle fractures were treated operatively. Among them, fifteen cases with more than 12 months follow-up were analyzed retrospectively. In Neer classification, type I was 1 case and 14 cases were type II. We performed closed reduction in 4 cases and open reduction in 11 cases. We treated with Steinman pin in I case, K-wires in 6 cases and coracoclavicular screw(Bosworth technique) in 6 cases. One case was treated with coracoclavicular screw due to screw loosening which was used in primary operation. Another case was treated by internal fixation with plate and K-wire due to delayed union after conservative treatment of segmental fracture. Mean follow up period was 18 months(12~62 months). Clinical results was evaluated by Kona s criteria.
RESULTS
Radiological evidence of solid union was detected within 10 weeks in 13 cases. Clinical results were satisfactory in 13 cases (excellent in 10 cases and good in 3 cases). In K-wire fixation, all six cases were demonstrated excellent result. In coracoclavicular screw fixation, four of six cases were excellent, one was good and one was fair. Poor result was noted in one case of Steinmann pin fixation due to nonunion and limitation of range of motion.
SUMMARY: Surgical treatment of distal claviclular fracture would obtain satisfactory clinical result with early range of motion exercise and reduce the complications such as nonunion and sustained pain.