Surgical Techniques for Percutaneous Reduction by Towel Clips and Percutaneous Intramedullary Fixation with Steinmann Pins for Clavicle Shaft Fractures

Ki-Do Hong; Jae-Chun Sim; Sung-Sik Ha; Tae-Ho Kim; Jong-Hyun Kim; Jong-Seong Lee

doi:10.12671/jkfs.2012.25.1.31

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Hong, Sim, Ha, Kim, Kim, and Lee: Surgical Techniques for Percutaneous Reduction by Towel Clips and Percutaneous Intramedullary Fixation with Steinmann Pins for Clavicle Shaft Fractures

Original Article

Journal of the Korean Fracture Society

Journal of the Korean Fracture Society 2012; 25(1): 31-37.

Published online: 31 January 2012

DOI: https://doi.org/10.12671/jkfs.2012.25.1.31

Surgical Techniques for Percutaneous Reduction by Towel Clips and Percutaneous Intramedullary Fixation with Steinmann Pins for Clavicle Shaft Fractures

Ki-Do Hong, M.D., Jae-Chun Sim, M.D., Sung-Sik Ha, M.D., Tae-Ho Kim, M.D., Jong-Hyun Kim, M.D., Jong-Seong Lee, M.D.

Department of Orthopedic Surgery, Sahmyook Medical Center, Seoul, Korea.

Address reprint requests to: Jae-Chun Sim, M.D. Department of Orthopedic Surgery, Sahmyook Medical Center, 29-1, Hwigyoung 2-dong, Dongdaemun-gu, Seoul 130-711, Korea. Tel: 82-2-2210-3581, Fax: 82-2-2217-1897, kjh2789@hanmail.net

Received 2 October 2011 Revised 7 November 2011 Accepted 5 December 2011

Abstract

Purpose

To report the clinical results of surgical treatment of clavicle shaft fracture by percutaneous reduction with towel clips and percutaneous intramedullary pin fixation.

Materials and Methods

This study reviewed the results of 80 cases of clavicle shaft fracture treated by percutaneous reduction with towel clips and percutaneous intramedullary pin fixation with Steinmann pins from January 2002 to August 2010, after follow-up for 12 months or more. We evaluated the clinical results, such as union time and complications.

Results

Bone union was evident in all cases and the mean time for bone union to appear on radiological findings was 10.3 weeks. Using Kang's criteria, 78 of the 80 patients (97.5%) showed good results and there were no severe complications.

Conclusion

Percutaneous reduction with towel clips and the percutaneous intramedullary pin fixation method showed good results for treating clavicle shaft fracture.

Keywords: Clavicle shaft fracture, Reduction with towel clip, Percutaneous intramedullary pin fixation

Figures and Tables

Fig. 1

The picture and the radiograph shows the percutaneous insertion of Steinmann pin into the intramedullary canal under the fluoroscopic guidance from the fracture side to the medial end.

Fig. 2

The picture and the radiograph shows reduction of the clavicle fracture with towel clip.

Fig. 3

The picture and the radiograph shows retrograde reinsertion of Steinmann pin after reduction of the fracture site under the fluoroscopic guide.

Fig. 4

The picture shows bending the remnant part of Steinmann pin.

Fig. 5

(A) The radiograph shows the displaced clavicle shaft fracture as Robinson classification type 2B1

(B) Immediate postoperative radiograph shows well reducted clavicle with percutaneous Steinmann pin fixation.

(C) Postoperative 12 weeks radiograph shows bone union.

Fig. 6

(A) Preoperative 3D computerized tomography shows displaced clavicle shaft fracture with double butterfly fragment as Robinson classification type 2B2.

(B) Immediate postoperative radiograph shows well reducted clavicle fracture with double butterfly fragments with Steinmann pin.

(C) Postoperative 12 weeks radiograph shows complete bone union with butterfly fragments and complete remodeling of clavicle fracture.

Fig. 7

(A) The radiograph shows the displaced clavicle shaft fracture as Robinson classification type 2B1.

(B) The radiograph shows the bended Steinmann pin due to slip down on 2 weeks after operation.

(C) Postoperative 12 weeks radiograph shows bone union and remodeling without any other procedure.

Table 1

Robinson classification of fractures

Table 2

Union time of the fracture

Table 3

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

Table 4

Complications

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