Clinical and radiological outcome following treatment of displaced lateral clavicle fractures using a locking compression plate with lateral extension: a prospective studyReportar como inadecuado




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BMC Musculoskeletal Disorders

, 15:380

Orthopedics and biomechanics

Abstract

BackgroundTreatment of lateral fractures of the clavicle is challenging and has been controversially discussed for a long time due to high non-union rates in non-operative treatment and high complication rates in surgical treatment. Acromioclavicular joint instability due to the injury of the closely neighbored coraco-clavicular ligaments can result in a cranialization of the medial clavicle shaft. A recently developed implant showed a promising functional outcome in a small collective of patients.

MethodsIn this prospective study, 20 patients with a mean age of 40.7 ± 11.3 years with a dislocated fracture of the lateral clavicle JägerandBreitner I-III, Neer I-III were enrolled. All patients were surgically treated using the locking compression plate LCP for the superior anterior clavicle Synthes®. Functional outcome was recorded using the Munich Shoulder Questionnaire MSQ allowing for qualitative self-assessment of the Shoulder Pain and Disability Index SPADI, of the Disability of the Arm, Shoulder and Hand DASH score and of the Constant Score. Acromioclavicular joint stability was evaluated using the Taft-Score.

ResultsThe mean follow-up was 14.2 ± 4.0 months. The mean MSQ was 87.0 ± 7.4 points, the mean SPADI 91.1 ± 11.3 points, the mean DASH score 7.6 ± 7.3 points and the mean normative age- and sex-specific Constant Score 85.6 ± 8.0 points. The mean Taft Score resulted in 10.7 ± 1.0 points. The mean Taft Score in lateral clavicular fractures with fracture gap between the coracoclavicular ligaments in combination with a rupture of the conoid ligament JandB II a, Neer II B; n =11 was with 10.3 ± 0.9 points significantly lower than the mean Taft Score of all other types of lateral clavicle fractures JandB I, II b, III; n =9 which resulted in 11.3 ± 0.9 points p < 0.05.

ConclusionsThe Synthes® LCP superior anterior clavicle plate allows for a safe stabilization and good functional outcome with high patient satisfaction in fractures of the lateral clavicle. However, in fractures type JägerandBreitner II a, Neer II B a significant acromioclavicular joint instability was observed and additional reconstruction of the coracoclavicular ligaments should be performed.

Trial registrationClinicalTrials.gov NCT02256059. Registered 02 October 2014.

KeywordsLateral clavicle fracture Distal clavicle fracture Locking compression plate Superior anterior clavicle plate with lateral extension Instability AbbreviationsACAcromio-clavicular

CCCoraco-clavicular

JandBJäger and Breitner

ORIFOpen reduction and internal fixation

MSQMunich shoulder questionnaire

SPADIShoulder pain and disability index

DASHDisability of the arm, shoulder and hand

LCPLocking compression plate.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2474-15-380 contains supplementary material, which is available to authorized users.

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Autor: Marc Beirer - Sebastian Siebenlist - Moritz Crönlein - Lukas Postl - Stefan Huber-Wagner - Peter Biberthaler - Chlodwig Ki

Fuente: https://link.springer.com/



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