J Korean Fract Soc.  2016 Jul;29(3):185-191. 10.12671/jkfs.2016.29.3.185.

Use of Composite Wiring on Surgical Treatments of Clavicle Shaft Fractures

• Kim KC
• Rhyou IH
• Lee JH
• Ahn KB
• Moon SC

• KMID: 2344091
• DOI: http://doi.org/10.12671/jkfs.2016.29.3.185

Abstract

PURPOSE
To introduce the technique of reducing displaced or comminuted clavicle shaft fracture using composite wiring and report the clinical results.
MATERIALS AND METHODS
Between March 2006 and December 2013, 31 consecutive displaced clavicle fractures (Edinburgh classification 2B) treated by anatomic reduction and internal fixation using composite wiring and plates were retrospectively evaluated. The fracture fragments were anatomically reduced and fixed with composite-wiring. An additional plate was applied. Radiographic assessments for the numbers of fragments, size of each fragment and amount of shortening and displacement were performed. The duration for fracture union and complications were investigated retrospectively. The mean fallow-up duration was 15.9 months.
RESULTS
The mean number of fragments was 1.7 (1-3) and the mean width of fracture fragment was 7.1 mm (4.5-10.6 mm). The mean shortening of the clavicle was 20.5 mm (10.3-36.2 mm). The mean number of composite wires used in fixation was 1.9 (1-3). Radiographic union was achieved in all patients with a mean time to union of 11.6 weeks. There were no complications including metal failure, pin migration, nonunion, or infection.
CONCLUSION
The composite wiring was suitable for fixation of small fracture fragment and did not interfere with the union, indicating that it is useful for treatment of clavicle shaft fracture.

Keyword

Clavicle shaft; Comminuted fracture; Open reduction; Composite wire fixation; Fracture union

MeSH Terms

Classification
Clavicle*
Fractures, Comminuted
Humans
Retrospective Studies

Figure

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  Fig. 1 The preoperative 3 dimensional-computed tomography shows segmental clavicle mid-shaft fractures (Edinburgh classification type 2B2).

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  Fig. 2 Intraoperative photograph showing segmental clavicle mid-shaft fractures.

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  Fig. 3 The fracture fragments were reduced and fixed by two composite-wires with minimal soft tissue dissection.

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  Fig. 4 The fracture was fixed in an anatomical position with the reconstruction plate and screws.

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  Fig. 5 The preoperative 3 dimensional-computed tomography shows segmental comminuted clavicle mid-shaft fractures (Edinburgh classification type 2B2).

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  Fig. 6 The small fracture fragments were fixed by three composite-wiring.

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  Fig. 7 Additional wiring over the plate was fixed to resist pull-out stress.

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  Fig. 8 The fracture was fixed in anatomical position with the reconstruction plate and screws.

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