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 Noncomminuted lateral end clavicle fractures associated with coracoclavicular ligament disruption: Technical considerations for optimal anatomic fixation and stability

Richard S Page1, Deepak N Bhatia2
1 St. John of God Hospital, Geelong, Victoria 3220, Australia
2 Department of Orthopaedic Surgery, Seth GS Medical College, King Edward VII Memorial Hospital, Parel, Mumbai, Maharashtra, India

Correspondence Address:
Deepak N Bhatia
Department of Orthopaedic Surgery, Seth GS Medical College, King Edward VII Memorial Hospital, Parel, Mumbai - 400 012, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-6042.140116

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Year : 2014  |  Volume : 8  |  Issue : 3  |  Page : 86-89

 
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Distal clavicle fractures associated with coracoclavicular ligament disruption are potentially unstable and necessitate surgical treatment. Current fixation techniques are nonanatomic and do not address relevant aspects of the pathoanatomy. We have developed a technique that uses a unique combination of implants; this permits minimally invasive fixation and stable reduction with a lateral fragment size as small as 5 mm. The surgical technique consists of (1) neutralization of muscular forces on the proximal fragment using a minimally invasive ligament repair device (TightRope™, Arthrex, FL, USA) and (2) internal fixation using a contour-matched locking plate (2.4 mm LCP® Distal radius plates, Synthes, USA). Technical tips to optimize this new procedure are discussed. The technique can be extended to an "arthroscopic-assisted" method involving arthroscopic coracoclavicular fixation followed by a mini-open plate fixation of the clavicular fragments.






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© 2006 - International Journal of Shoulder Surgery
| Published by Wolters Kluwer - Medknow Online since 1st September '06

 

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Richard S Page1, Deepak N Bhatia2
1 St. John of God Hospital, Geelong, Victoria 3220, Australia
2 Department of Orthopaedic Surgery, Seth GS Medical College, King Edward VII Memorial Hospital, Parel, Mumbai, Maharashtra, India

Correspondence Address:
Deepak N Bhatia
Department of Orthopaedic Surgery, Seth GS Medical College, King Edward VII Memorial Hospital, Parel, Mumbai - 400 012, Maharashtra
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-6042.140116

Get Permissions

Distal clavicle fractures associated with coracoclavicular ligament disruption are potentially unstable and necessitate surgical treatment. Current fixation techniques are nonanatomic and do not address relevant aspects of the pathoanatomy. We have developed a technique that uses a unique combination of implants; this permits minimally invasive fixation and stable reduction with a lateral fragment size as small as 5 mm. The surgical technique consists of (1) neutralization of muscular forces on the proximal fragment using a minimally invasive ligament repair device (TightRope™, Arthrex, FL, USA) and (2) internal fixation using a contour-matched locking plate (2.4 mm LCP® Distal radius plates, Synthes, USA). Technical tips to optimize this new procedure are discussed. The technique can be extended to an "arthroscopic-assisted" method involving arthroscopic coracoclavicular fixation followed by a mini-open plate fixation of the clavicular fragments.






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© 2006 - International Journal of Shoulder Surgery
| Published by Wolters Kluwer - Medknow Online since 1st September '06