Coracoclavicular screw fixation for treatment of unstable distal clavicle fractures / 中国矫形外科杂志

ABSTRACT

[Objective]To retrospectively analyze of functional and radiographic outcome of distal calvicle fractures (Neer type II) treated with coracoclavicular screw fixation.[Method]Fifteen patients with Neer type II distal clavicle fracture were treated surgically between March 2001 and March 2004.Operative treatment included open reduction and fixation of the proximal clavicular fragment to the coracoid process using a 6.5-mm cancellous screw and repair of the coracoclavicular ligaments.Perioperative radiographs were performed to ensure that the screw was introduced properly into the coracoid.Following the operation,the arm was placed in a sling for two weeks.After two weeks,the sling was discontinued and the patient was permitted to use the arm for daily activities except for lifting,pulling,and pushing for 6 weeks.The patient is instructed not to perform any heavy lifting,pushing,pulling or participate in contact sports for 3 months.Data were collected to allow scoring according to the American Shoulder and Elbow Surgeons shoulder index 6 months after operation.[Result]All the patients were followed up at an average of 16 months (range9~26 months).Fracture union occurred at a mean of 7 weeks (range6~9 weeks)postoperatively without any serious complications such as screw-migration,pseudarthrosis,infection,neurovascular damage,or skin necrosis.All patients returned to the pre-injury level of activity with no residual pain or dysfunction.The mean American Shoulder and Elbow Surgeons shoulder index was 97 points ( range 90-100 points) 6 months after operation.Two patients showed radiologically ossification of the acromioclavicular joint with no clinical symptoms.[Conclusion]Coracoclavicular screw fixation is a relatively simple,reliable,and safe technique of open reduction and internal fixation of the type II distal clavicle fracture.