Skip to main content
Top
Published in: European Journal of Trauma and Emergency Surgery 1/2020

01-02-2020 | Original Article

Displaced medial clavicle fractures: operative treatment with locking compression plate fixation

Authors: Herman Frima, Roderick M. Houwert, Christoph Sommer

Published in: European Journal of Trauma and Emergency Surgery | Issue 1/2020

Login to get access

Abstract

Objectives

Medial clavicle fractures are rare injuries and historically treated non-operatively. Displaced medial clavicle fractures, however, have a higher incidence of delayed- or non-union compared to non- displaced medial clavicle fractures and might benefit from operative treatment. We describe below a new technique for treating intra-articular fractures or extra-articular fractures with a small medial fragment using special locking plates and present the results of our operatively treated patients.

Methods

First we describe our technique for treating very medial fractures with the radial (VA)-LCP™ Distal Humerus Plate (DePuy Synthes, Switzerland). Second, a retrospective cohort study was performed. All patients operated on for a displaced medial clavicle fracture between 2010 and 2017 were included. Primary outcome was the QuickDASH score and the Subjective Shoulder Value (SSV). Secondary outcomes were operative complications including mal- or non-union and implant removal.

Results

All 15 patients were available for follow-up. Fourteen patients were included in our analysis. One patient was excluded due to severe concomitant injuries. Six patients were treated with the radial (VA)-LCP™ Distal Humerus Plate, eight patients with the LCP™ Superior Anterior Clavicle Plate with lateral extension (DePuy Synthes, Switzerland) and one with a LCP 3.5 plate. The mean follow-up was 39 months (range 9–79). The mean QuickDASH score was 0.81 (range 0–4.50, SD ± 1.44) and the mean SSV was 96 (range 80–100, SD ± 6.53). One patient had an early revision operation and developed an infection after 1.5 years. No mal- or non-unions occurred. Eight patients had their implants removed.

Conclusions

Operative treatment of displaced medial clavicle fractures with well-fitting ‘small fragment’ locking plates provides an excellent long-term functional outcome. Intra-articular fractures or extra-articular fractures with a small medial fragment can be treated with the radial (VA)-LCP™ Distal Humerus Plate.
Literature
2.
go back to reference Robinson CM. Fractures of the clavicle in the adult. Epidemiology and classification. J Bone Joint Surg Br. 1998;80(3):476–84.CrossRef Robinson CM. Fractures of the clavicle in the adult. Epidemiology and classification. J Bone Joint Surg Br. 1998;80(3):476–84.CrossRef
3.
go back to reference Robinson CM, Court-Brown CM, McQueen MM, Wakefield AE. (2004) Estimating the risk of nonunion following nonoperative treatment of a clavicular fracture. J Bone Joint Surg Am 86-a (7):1359–1365. Robinson CM, Court-Brown CM, McQueen MM, Wakefield AE. (2004) Estimating the risk of nonunion following nonoperative treatment of a clavicular fracture. J Bone Joint Surg Am 86-a (7):1359–1365.
13.
go back to reference Marsh JL, Slongo TF, Agel J, Broderick JS, Creevey W, DeCoster TA, Prokuski L, Sirkin MS, Ziran B, Henley B, Audige L. Fracture and dislocation classification compendium – 2007: Orthopaedic Trauma Association classification, database and outcomes committee. J Orthop Trauma. 2007;21(10 Suppl):1–133.CrossRef Marsh JL, Slongo TF, Agel J, Broderick JS, Creevey W, DeCoster TA, Prokuski L, Sirkin MS, Ziran B, Henley B, Audige L. Fracture and dislocation classification compendium – 2007: Orthopaedic Trauma Association classification, database and outcomes committee. J Orthop Trauma. 2007;21(10 Suppl):1–133.CrossRef
16.
go back to reference Jost B, Pfirrmann CW, Gerber C, Switzerland Z. Clinical outcome after structural failure of rotator cuff repairs. J Bone Joint Surg Am. 2000;82(3):304–14.CrossRef Jost B, Pfirrmann CW, Gerber C, Switzerland Z. Clinical outcome after structural failure of rotator cuff repairs. J Bone Joint Surg Am. 2000;82(3):304–14.CrossRef
17.
go back to reference Wright RW, Baumgarten KM. Shoulder outcomes measures. J Am Acad Orthop Surg. 2010;18(7):436–44.CrossRef Wright RW, Baumgarten KM. Shoulder outcomes measures. J Am Acad Orthop Surg. 2010;18(7):436–44.CrossRef
Metadata
Title
Displaced medial clavicle fractures: operative treatment with locking compression plate fixation
Authors
Herman Frima
Roderick M. Houwert
Christoph Sommer
Publication date
01-02-2020
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Trauma and Emergency Surgery / Issue 1/2020
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-018-1024-6

Other articles of this Issue 1/2020

European Journal of Trauma and Emergency Surgery 1/2020 Go to the issue