Does Interfragmentary Cerclage Wire Fixation in Clavicle Shaft Fracture Interfere the Fracture Healing?

Jae-Kwang Yum; Yong-Woon Shin; Hee-Sung Lee; Jae-Gu Park

doi:10.12671/jkfs.2011.24.2.138

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Yum, Shin, Lee, and Park: Does Interfragmentary Cerclage Wire Fixation in Clavicle Shaft Fracture Interfere the Fracture Healing?

Original Article

Journal of the Korean Fracture Society

Journal of the Korean Fracture Society 2011; 24(2): 138-143.

Published online: 19 April 2011

DOI: https://doi.org/10.12671/jkfs.2011.24.2.138

Does Interfragmentary Cerclage Wire Fixation in Clavicle Shaft Fracture Interfere the Fracture Healing?

Jae-Kwang Yum, M.D., Ph.D., Yong-Woon Shin, M.D., Hee-Sung Lee, M.D., Jae-Gu Park, M.D.

Department of Orthopedic Surgery, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.

Address reprint requests to: Yong-Woon Shin, M.D. Department of Orthopedic surgery, Sanggye Paik Hospital, Inje University College of Medicine, 761-1, Sanggye 7-dong, Nowon-gu, Seoul 139-707, Korea. Tel: 82-2-950-1032, Fax: 82-2-934-6342, woonysos@hanmail.net

Received 22 November 2010 Revised 6 January 2011 Accepted 4 March 2011

(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

A technique of cerclage wire fixation in comminuted fracture of the clavicle shaft is thought to interfere the fracture healing, so authors studied radiographically and clinically about the cases of cerclage wiring of the fracture fragments with the plate and screws fixation in the comminuted fracture of the shaft of the clavicle.

Materials and Methods

According to following inclusion criteria, total 18 patients (male: 15, female: 3) were investigated; Patients who visited hospital due to clavicle shaft comminuted fracture from February 2005 to April 2009, who underwent surgery utilizing more than 2 cerclage wire fixation for the fragments when open reduction and plate fixation were operated and who could be follow-up over one year. The duration for fracture union, functional outcome and complications were investigated retrospectively.

Results

Radiological bone union was accomplished in average 13.3 weeks (12~16 weeks) and there was no complication such as nonunion, delayed union or infection. Range of motion of ipsilateral shoulder joint was recovered in all patients except one at the final follow-up.

Conclusion

The clinical and radiographical results of the plate and screws fixation with cerclage wiring of the fragments in comminuted clavicle shaft fracture showed that the cerclage wiring does not interfere the fracture healing, so authors think that this method is a good alternative operation if it is performed carefully to minimize soft tissue dissection.

Keywords: Clavicle shaft, Comminuted fracture, Open reduction, Cerclage wire fixation, Fracture union

Figures and Tables

Fig. 1

(A) Two cerclage wires tie up the fracture fragment with minimal soft tissue dissection.

(B) Fracture fixation is performed in anatomical position with the reconstruction plate and screws.

Fig. 2

(A) The preoperative radiograph shows comminuted fracture of the clavicle shaft.

(B) Immediate postoperative radiograph shows comminuted clavicle shaft fracture is fixed by reconstruction plate and screws with three cerclage wires.

Fig. 3

The simple radiograph shows gap between cortical bone and wires (black arrows).

Table 1

Factors for evaluation of results and clinical scoring system by Kang et al

Table 2

Details of 18 patients of clavicle shaft comminuted fractures treated by open reduction and internal fixation using plate and cerclage wires

^*MVA: motor vehicle accident, ^†Edingurgh classification, ^‡Kang's criteria.

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