Modified Spring Plate for Treatment of Unstable Distal Clavicle Fractures

Sang-Myung Lee; Il-Jung Park; Hyung-Min Kim; Jae-Chul Park; Sung-Gil Cho; Yoon-Chung Kim; Seung-Koo Rhee

doi:10.12671/jkfs.2010.23.1.64

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Lee, Park, Kim, Park, Cho, Kim, and Rhee: Modified Spring Plate for Treatment of Unstable Distal Clavicle Fractures

Original Article

Journal of the Korean Fracture Society

Journal of the Korean Fracture Society 2010; 23(1): 64-68.

Published online: 31 January 2010

DOI: https://doi.org/10.12671/jkfs.2010.23.1.64

Modified Spring Plate for Treatment of Unstable Distal Clavicle Fractures

Sang-Myung Lee, M.D., Il-Jung Park, M.D.^*, Hyung-Min Kim, M.D.^*, Jae-Chul Park, M.D., Sung-Gil Cho, M.D., Yoon-Chung Kim, M.D., Seung-Koo Rhee, M.D.

Department of Orthopedic Surgery, St. Mary's Hospital, Seoul, Korea.

^*Department of Orthopedic Surgery, Bucheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Bucheon, Korea.

Address reprint requests to: Seung-Koo Rhee, M.D. Department of Orthopedic Surgery, St. Mary's Hospital, The Catholic University of Korea College of Medicine, 60, Yeouido-dong, Yeongdeungpo-gu, Seoul 150-713, Korea. Tel: 82-2-3779-1192, Fax: 82-2-783-0252, skrhee@catholic.ac.kr

Received 8 July 2009 Revised 26 October 2009 Accepted 15 December 2009

(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

Unstable distal clavicle fractures should be treated surgically but may be difficult in firm fixation because of small distal fragment. Although a variety of fixation methods have been currently used, none of the methods seem to be firm fixation and little pain. We present a new technique using a spring plate which was modified from one third tubular plate and report the early results.

Materials and Methods

Modified spring plate was made from one third tubular plate and the distal hole of the plate was cutting and sharpened by rasp. The sharp edge was bent just like an animal claw (C shape). Between May 2007 and June 2009, a total of six patients with distal clavicle fracture were treated using modified spring plate. A sling was applied in the immediate post operative period for six weeks and exercises were started immediately.

Results

Union was achieved in all cases with excellent results without complication (mean Constant score, 96). All patients had returned to ordinary daily activities but mild limitation of abduction (150°) by seven weeks after surgery. After six months, the plate was removed.

Conclusion

The modified spring plate has provided stable fixation for unstable distal clavicle fixation without disturbance to the acromioclavicular joint, subacromial space, or rotator cuff.

Keywords: Distal clavicle fracture, Modified spring plate, Acromioclavicular joint, Subacromial space, Rotator cuff

Figures and Tables

Fig. 1

Close up photograph of modified spring plate. A newly designed spring plate which is made from ordinary one third tubular plate; The distal hole of the plate was cutting and sharpened by rasp. The sharp edge was bent just like an animal claw (C shape).

Fig. 2

(A) Distal clavicle comminuted fracture in a 47-year-old man.

(B) After modified spring plate fixation. Note the acromioclavicular joint subluxation caused by acromioclavicular ligament damage.

(C) After removal of modified spring plate.

Fig. 3

(A) Distal clavicle fracture in a 46-year-old man.

(B) After modified spring plate fixation.

Table 1

Summary of cases

^*Fracture type by Neer classification (1963), ^†MVA: Motor vehicle accident.

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