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Clin Shoulder Elbow > Volume 14(1); 2011 > Article
Clinics in Shoulder and Elbow 2011;14(1):59-66.
DOI: https://doi.org/10.5397/CiSE.2011.14.1.059    Published online June 30, 2011.
Operative Treatment of Distal Clavicle Fracture with Acromioclavicular Joint Injury
Ho Jung Kang, Il Hyun Koh, Jong Hwan Joo, Yong Min Chun, Hyung Sik Kim
Department of Orthopaedic Surgery, Yonsei University, College of Medicine, Seoul, Korea. kihro@yuhs.ac.kr
견봉 쇄골 관절의 손상을 동반한 원위 쇄골 골절의 수술적 치료
강호정·고일현·주종환·천용민·김형식
연세대학교 의과대학 정형외과학교실
Abstract
PURPOSE
We wanted to evaluate the clinical and radiological outcomes and the prognosis of various surgical treatments for the distal clavicle fracture with an acromioclavicular joint injury. MATERIALS AND METHODS: A retrospective study of 21 patients with a minimum of 12 months follow up was done. We classified acromioclavicular (AC) injury into type I (only intra-articular fracture (IAF), 5 cases), type II (IAF with widening of the AC joint > 7 mm, 9 cases) and type III (IAF with AC joint superior subluxation > 50%, 7 cases). The distal clavicle fractures were fixed using plate (9 cases), mini screws (1 case), K wire and tension band wiring (10 cases) and transarticular pinning (1 case). Acromioclavicular or coracoacromial ligament reconstruction was not done in all the cases.
RESULTS
In 20 of 21 cases, bone union was achieved at an average of 8.4 weeks. Traumatic arthritis (5 cases), AC joint widening (4 cases) and AC joint subluxation (2 cases) were noted at the last follow up. The average UCLA score was 32.6 in the type I AC joint injuries, 34 in type II and 34.1 in type III. There was no relationship between the clinical outcomes and the preoperative AC joint injury pattern, postoperative traumatic arthritis, AC joint widening or AC joint subluxation (p>0.05).
CONCLUSION
Satisfactory results were achieved by acute reduction and firm fixation of the distal clavicle fracture with AC joint injury. There was no relationship between the pattern of AC joint injury, the residual radiologic findings and the functional outcome.
Key Words: Distal clavicle fracture; Acromioclavicular joint injury; Internal fixation


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