Double Tension Band Wire Fixation for Unstable Fracture of the Distal Clavicle

Kyeong-Seop Song; Hyung-Gyu Kim; Byeong-Mun Park; Jong-Min Kim; Sung-Hoon Jung; Bong-Seok Yang

doi:10.12671/jkfs.2009.22.1.24

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Song, Kim, Park, Kim, Jung, and Yang: Double Tension Band Wire Fixation for Unstable Fracture of the Distal Clavicle

Original Article

Journal of the Korean Fracture Society 2009; 22(1): 24-29.

Published online: 31 January 2009

DOI: https://doi.org/10.12671/jkfs.2009.22.1.24

Double Tension Band Wire Fixation for Unstable Fracture of the Distal Clavicle

Kyeong-Seop Song, M.D., Hyung-Gyu Kim, M.D., Byeong-Mun Park, M.D., Jong-Min Kim, M.D., Sung-Hoon Jung, M.D., Bong-Seok Yang, M.D.

Department of Orthopaedic Surgery, Kwangmyung Sung-Ae Hospital, Gwangmyeong, Korea.

Address reprint requests to: Hyung-Gyu Kim, M.D. Department of Orthopedic Surgery, Kwangmyung Sung-Ae Hospital, 389, Chulsan 3-dong, Gwangmyung 423-711, Korea. Tel: 82-2-2680-7236, Fax: 82-2-2617-9039, khg0623@hanmail.net

Received 11 October 2008 Accepted 10 November 2008

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the clinical results after operative treatment with the double tension band wire fixation in Neer type II and III distal clavicle fractures.

Materials and Methods

Ten patients with type II and III distal clavicle fractures were evaluated, who operated with double tension band wire fixation technique, from Febrary 2007 to June 2008, and could be followed-up for more than 1 year after operation. Postoperative assessments were evaluated on plain x-ray, pain, and clinical finding according to the functional criteria by Kona et al.

Results

Average duration from operation to fracture union was 8 weeks in all cases. There were 8 excellent and 2 good results. It was no other significant complications such as K-wire migration, breakage, infection, and AC joint arthritis.

Conclusion

Double tension band wire fixation technique seems to be an effective method for type II or III distal clavicle fracture with multiple compressive axis, without injury of the AC joint and loosening of the fixation.

Keywords: Distal clavicle fracture, Double tension band wire fixation

Figures and Tables

Fig. 1

Illustrations of the surgical technique of double tension band wire fixation for distal clavicle.

(A) Insertion two K-wires from distal to proximal and one K-wire from anteior to posterior for typical tension band wire fixation.

(B) Insertion of one more K-wire from anterior to posterior at distal fragment and another tension band wire fixation over the fracture site.

Fig. 2

A demonstration model of the double tension band wire fixation.

Fig. 3

A 32-years-old male was injured by traffic accident.

(A) The radiograph shows a type IIb unstable distal clavicle fracture with a long transverse fragment.

(B) The fracture is fixed with double tension band wire and additional two circular wires.

(C) After removal of the implats at postoperative 14 months, complete union of the fracture site is seen.

Fig. 4

A 17-years-old female was injured by slip down.

(A) The radiograph shows a type IIb unstable distal clavicle fracture.

(B) Postoperative radiograph shows the fracture fixed with double tension band wire.

(C) Fracture is united in 6 weeks after surgery on radiograph.

Table 1

Demographic data of the patients

^*Double tension band wire, ^†Circular wire.

Table 2

Classification of functional results by Kona et al.

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