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European Journal of Orthopaedic Surgery & Traumatology

Erschienen in:

26.11.2021 | Original Article

Operative management of lateral third clavicle fractures: a comparison of internal fixation methods

verfasst von: Patrick Hickland, Christopher Goodland, Sunil Zachariah, Lynn E Murphy, Martyn Neil

Erschienen in: European Journal of Orthopaedic Surgery & Traumatology | Ausgabe 1/2023

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Abstract

Purpose

Clavicle fractures in the lateral third are associated with more complications. Various methods of internal fixation exist; however, there is no consensus which should be employed. The purpose of this study was to evaluate the outcomes of these various methods in our regional trauma unit.

Methods

We performed a retrospective review of patients who underwent internal fixation of a lateral clavicle fracture in our unit between 1 August 2014 and 31 July 2019. Demographic and outcome data were extracted from electronic care records and imaging systems.

Results

In total, 44 patients were included, with the following demographics: mean age 26 years, 63.6% male, 65.9% high-energy injury, 68.2% Neer II fracture. The following operations were performed: hook plate fixation (HPF) = 10, locking plate fixation (LPF) = 16, coracoclavicular ligament reconstruction (CCLR) = 12, and LPF + CCLR = 6. Patients having LPF had a significantly larger post-operative coracoclavicular distance (7.6 mm vs 13.5 mm, p < 0.01), and trends towards a lesser decrease in CCD (9.9 mm vs 12.6 mm, p = 0.37) and incomplete ACJ reduction (50.0% vs 89.3%, p = 0.11). There was a significantly higher re-operation rate after HPF (100% vs 23.5%, p < 0.01). There were no differences in time to union or duration of follow-up.

Conclusion

In our unit there is no clearly favoured method of internal fixation of lateral clavicle fractures. When LPF is used, there should be consideration of concomitant CCLR. The high rate of re-operation after HPF is concordant with previous research.

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Titel: Operative management of lateral third clavicle fractures: a comparison of internal fixation methods
verfasst von: Patrick Hickland
Christopher Goodland
Sunil Zachariah
Lynn E Murphy
Martyn Neil
Publikationsdatum: 26.11.2021
Verlag: Springer Paris
Erschienen in: European Journal of Orthopaedic Surgery & Traumatology / Ausgabe 1/2023
Print ISSN: 1633-8065
Elektronische ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-021-03173-z

Correction to: Is magnetic resonance imaging needed for decision making diagnosis and treatment of thoracic and lumbar vertebral fractures?

Correction

Is magnetic resonance imaging needed for decision making diagnosis and treatment of thoracic and lumbar vertebral fractures?

Original Article

Distal third clavicle fractures treated with anatomical locking plates with or without coraco-clavicular ligament augmentation: why not an intraoperative decision?

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Operative management of lateral third clavicle fractures: a comparison of internal fixation methods