Follow-up Study of Fractures of the Distal Clavice

DOI 2 Citations 6 References
  • Shibuta H.
    Department of Orthopaedic Surgery, Yokohama Rosai Hospital
  • Tabuchi K.
    Department of Orthopaedic Surgery, Yokohama Rosai Hospital
  • Iwaso H.
    Department of Orthopaedic Surgery, Yokohama Rosai Hospital
  • Tamai K.
    Department of Otrthopaedic Surgery, Dokkyo University School of medicine

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Other Title
  • 鎖骨遠位端骨折の治療経験

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Description

The purpose of this report is to review the results of Kirschner wire fixation for fractures of the distal clavicle.<BR>We retrospectively studied 27 cases over 3 years. According to the Neer's classification,9fractures were type I and 18 fractures were type II. The average age was 44 years in type I and 38.5 years in type II. Type I fractures were treated with a sling in 6 cases and a figure eight bandage in 3 cases. Type II fractures were divided into 2 types. One was a fracture in which the distal fragment was uncommunited, and the other was a fracture in which the distal fragment was communited. Fractures with uncommunited distal fragments were treated by transacromial fixations with Kirschner wires (13 cases) or by fracture fixations with Kirschner wires (2 cases). Fractures with communited distal fragments were treated by transacromial fixations with Kirschner wires after resections of the distal fragments and reconstruction of the coracoclavicular ligaments (2 cases) or open reduction and internal fixation with a screw and transacromial Kirschner wire fixation (1 case).<BR>Patients with a type I fracture obtained excellent results. Of the 13 patients with a type II fracture who were followed-up for more than 3 months after their operations, one could not elevate his limb due to hemiplegia, and two had mild pain in their daily activities. Dalayed union occured in one case and nonunion occured in another. Proximal fragment displaced superiorly more than 5mm after removal of the Kischner wires in two cases, of which, one had a nonunion. All those who revealed a delayed union, a nonunion, or a superiorly displacement of the proximal fragment had an uncommunited and large distal fragment. Kirschner wire fixation may not be the treatment of choice for a type II fracture with a large distal fragment.

Journal

  • Katakansetsu

    Katakansetsu 19 (1), 73-77, 1995

    Japan Shoulder Society

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