Jae-Myeung Chun1, Soung-Yon Kim. 1. Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.
Abstract
BACKGROUND: Optimal surgical treatment of unstable distal clavicle fractures is controversial, and various fixation options are available. The objective of this study was to evaluate a new modified tension band fixation technique for unstable distal clavicle fractures. METHODS: Forty-two patients with acute unstable distal clavicle fractures were managed with open reduction and internal fixation using modified tension band fixation. All patients had radiographic and clinical follow-ups at a minimum of 12 months (range, 12-39 months). Bony union and coracoclavicular interval distance were evaluated radiographically. Clinical outcomes were measured with the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form. RESULTS: All fractures united solidly within 3 months. All patients had a good functional result, with a mean American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form score of 92 points and a coracoclavicular interval distance of 8.7 mm (range, 5-14 mm; 1.24 times of normal shoulder) at the final follow-up. CONCLUSION: Surgical treatment for unstable distal clavicle fractures using modified tension band fixation is effective. This technique allows simple, cost-effective, and minimally invasive fixation with universally available implants and good fracture healing.
BACKGROUND: Optimal surgical treatment of unstable distal clavicle fractures is controversial, and various fixation options are available. The objective of this study was to evaluate a new modified tension band fixation technique for unstable distal clavicle fractures. METHODS: Forty-two patients with acute unstable distal clavicle fractures were managed with open reduction and internal fixation using modified tension band fixation. All patients had radiographic and clinical follow-ups at a minimum of 12 months (range, 12-39 months). Bony union and coracoclavicular interval distance were evaluated radiographically. Clinical outcomes were measured with the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form. RESULTS: All fractures united solidly within 3 months. All patients had a good functional result, with a mean American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form score of 92 points and a coracoclavicular interval distance of 8.7 mm (range, 5-14 mm; 1.24 times of normal shoulder) at the final follow-up. CONCLUSION: Surgical treatment for unstable distal clavicle fractures using modified tension band fixation is effective. This technique allows simple, cost-effective, and minimally invasive fixation with universally available implants and good fracture healing.