Journal List > J Korean Fract Soc > v.29(2) > 1038056

Chae, Choi, and Kim: Usefulness of the Additional K-Wire Fixation and Suture for Reinforce the Treatment of Distal Clavicle Fracture Using Modified Tension Band Wiring

Abstract

Purpose

We attempted to evaluate the clinical results of modified tension band wiring (MTBW) with additional K-wire fixation and suture for distal clavicle fracture.

Materials and Methods

Fifty-nine patients with a distal clavicle fracture from May 2009 to December 2013 treated with MTBW were enrolled in this study. Their fracture types were type 2, 12; and type 3, 33; type 4, 8; and type 5, 6 according to Craig classification group II; average age was 47.2 years with a mean follow-up period of 27.9 months. The operations were performed within a mean of 3.1 days a fter t rauma. The c linical results were evaluated u sing University of California at Los Angeles scores (UCLA), American Shoulder and Elbow Surgeons scores (ASES) and Korean Shoulder Society scores (KSS) at 1 year after surgery.

Results

Radiographic bone union was achieved at a mean of 3.7 months after the operation. In the last observation, their range of motion was forward flexion 159.0°, external rotation 59.8°, and internal rotation 4.3 points, and there were 2 cases of nonunion. Each average functional score was UCLA 31.3 points, KSS 91.6 points, and ASES 93.0 points.

Conclusion

For the surgical treatment of distal clavicle fractures, MTBW with additional K-wire fixation and suture is a useful technique allowing early range of motion exercises, minimizing soft tissue damage, and preserving the acromio-clavicular joint.

Figures and Tables

Fig. 1

(A) A 46-year-old male sustained a Neer type IIb right distal clavicle fracture. (B) The fracture was reduced with modified tension band wiring. (C) The last follow-up (postoperative day 4 months) radiograph shows solid union.

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Fig. 2

(A) A 16-year-old male sustained a Neer type IIb left distal clavicle fracture. (B) The fracture was reduced with modified tension band wiring (MTBW). Ahead of MTBW, K-wire fixation on the displaced bone fragment (arrow). (C) The last follow-up (postoperative day 5 months) radiograph shows solid union. (D) K-wire fixation on the displaced bone fragment (arrow), which affords additional stability maintaining reduction of the displaced fracture segment.

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Fig. 3

Small bone fragment fixation with non-absorbable suture material (arrow), which affords stability of the fracture site as well as soft tissue healing.

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Notes

Financial support None.

Conflict of interest None.

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