Effectiveness analysis of distal radius microplate locking plate for treatment of displaced fracture of medial clavicle_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZENG Jinyuan ,  YE Junjian , XIE Yun , CHEN Chunyong , LIN Zhangxiong

Department of Orthopedic Trauma, the First Affiliated Hospital of Fujian Medical University, Fuzhou Fujian, 350005, P.R.China;

Corresponding?author：

YE Junjian, Email: yejunjian@sohu.com

Keywords：

Distal radius microplate locking plate; medial clavicle fracture; internal fixation

DOI：

10.7507/1002-1892.201808113

Video：

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Objective To investigate and evaluate the effectiveness of the distal radius microplate locking plate for the treatment of displaced fracture of medial clavicle.Methods Between January 2013 and June 2017, 18 cases of obvious displaced fracture of medial clavicle were treated with distal radius microlocking plate. There were 10 males and 8 females, with an average age of 51.4 years (range, 18-88 years). Causes of injury included traffic accident injury in 15 cases, heavy object injury in 3 cases; all of them were closed injury. According to Edinburgh classification, 15 cases were ⅠB1 type and 3 cases were ⅠB2 type. Fracture displacement was 12-21 mm (mean, 16.3 mm). The time from injury to operation was 3-7 days (mean, 4.3 days). After operation, the clinical healing and complications of fracture were observed, and shoulder function was evaluated according to Rockwood’s scoring criteria.Results No incisional infection, neurovascular injury, or other early complications occurred. All 18 patients were followed up 8-15 months (mean, 12 months). All fractures reached clinical osseous union, and the healing time was 8-24 weeks (mean, 16.6 weeks). Postoperative plate loosening occurred in 1 case, which was removed surgically, while other patients did not suffer from complications such as bone nonunion, displacement, internal fixator loosening, and loss of reduction. At last follow-up, according to Rockwood’s scoring criteria, the results were excellent in 12 cases and good in 6 cases.Conclusion The distal radius microplate locking plate is effective for the treatment of displaced medial clavicle fracture, which has few complications, and is feasible for early functional exercise, and is helpful for the recovery of shoulder joint function.

Citation： ZENG Jinyuan, YE Junjian, XIE Yun, CHEN Chunyong, LIN Zhangxiong. Effectiveness analysis of distal radius microplate locking plate for treatment of displaced fracture of medial clavicle. Chinese Journal of Reparative and Reconstructive Surgery, 2019, 33(5): 527-530. doi: 10.7507/1002-1892.201808113 Copy

1.	吳曉明, 李凡, 高偉, 等. 胸鎖關節外鎖骨近端骨折的治療. 中華創傷骨科雜志, 2013, 15(4): 277-282.
2.	Oe K, Gaul L, Hierholzer C, et al. Operative management of periarticular medial clavicle fractures-report of 10 cases. J Trauma Acute Care, 2012, 72(2): E1-E7.
3.	Bartonícek J, Fric V, Lunácek L. Fractures of sternal end of the clavicle—current concept review. Rozhl Chir, 2008, 87(9): 480-485.
4.	McKenna M. Plating of a periarticular medial clavicle fracture. Orthopedics, 2009, 32(5): 366.
5.	O’Neill BJ, Hirpara KM, O’Briain D, et al. Clavicle fractures: a comparison of five classification systems and their relationship to treatment outcomes. Int Orthop, 2011, 35(6): 909-914.
6.	Rockwood CA Jr, Groh GI, Wirth MA, et al. Resection arthroplasty of the sternoclavicular joint. J Bone Joint Surg (Am), 1997, 79(3): 387-393.
7.	Stillwell A, Ioannou C, Daniele L, et al. Osteosynthesis for clavicle fractures: How close are we to penetration of neurovascular structures? Injury, 2017, 48(2): 460-463.
8.	Wang Y, Jiang J, Dou B, et al. Inverted distal clavicle anatomic locking plate for displaced medial clavicle fracture. Arch Orthop Trauma Surg, 2015, 135(9): 1241-1245.
9.	Robinson L, Persico F, Lorenz E, et al. Clavicular caution: an anatomic study of neurovascular structures. Injury, 2014, 45(12): 1867-1869.
10.	Clitherow HD, Bain GI. Association between screw prominence and vascular complications after clavicle fixation. Int J Shoulder Surg, 2014, 8(4): 122-126.
11.	Ding M, Hu J, Ni J, et al. Iatrogenic subclavian arteriovenous fistula: rare complication of plate osteosynthesis of clavicle fracture. Orthopedics, 2012, 35(2): e287-e289.
12.	Sidhu VS, Hermans D, Duckworth DG. The operative outcomes of displaced medial-end clavicle fractures. J Shoulder Elbow Surg, 2015, 24(11): 1728-1734.
13.	Bartonícek J, Fric V, Pacovsky V. Displaced fractures of the medial end of the clavicle: report of five cases. J Orthop Trauma, 2010, 24(4): e31-e35.
14.	Fransen P, Bourgeois S, Rommens J. Kirschner wire migration causing spinal cord injury one year after internal fixation of a clavicle fracture. Acta Orthop Belg, 2007, 73(3): 390-392.
15.	Gille J, Schulz A, Wallstabe S, et al. Hook plate for medial clavicle fracture. Indian J Orthop, 2010, 44(2): 221-223.
16.	稅巍, 張喜海, 陽運康, 等. T 型鎖定鋼板內固定治療鎖骨內側端骨折的臨床療效. 中國修復重建外科雜志, 2010, 24(8): 897-899.
17.	Kim KC, Shin HD, Cha SM. Surgical treatment of displaced medial clavicle fractures using a small T-shaped plate and tension band sutures. Arch Orthop Trauma Surg, 2011, 131(12): 1673-1676.
18.	楊琨, 陽運康, 葛建華, 等. 胸鎖關節解剖鎖定鋼板的研制及生物力學研究. 中國修復重建外科雜志, 2018, 32(1): 7-13.
19.	Alajmo G, Schlegel U, Gueorguiev B, et al. Plunging when drilling: effect of using blunt drill bits. J Orthop Trauma, 2012, 26(8): 482-487.
20.	孫遠林, 陽運康, 葛建華, 等. 新型胸鎖關節解剖鎖定鋼板的研制與臨床應用. 中國修復重建外科雜志, 2018, 32(3): 316-321.

1. 吳曉明, 李凡, 高偉, 等. 胸鎖關節外鎖骨近端骨折的治療. 中華創傷骨科雜志, 2013, 15(4): 277-282.
2. Oe K, Gaul L, Hierholzer C, et al. Operative management of periarticular medial clavicle fractures-report of 10 cases. J Trauma Acute Care, 2012, 72(2): E1-E7.
3. Bartonícek J, Fric V, Lunácek L. Fractures of sternal end of the clavicle—current concept review. Rozhl Chir, 2008, 87(9): 480-485.
4. McKenna M. Plating of a periarticular medial clavicle fracture. Orthopedics, 2009, 32(5): 366.
5. O’Neill BJ, Hirpara KM, O’Briain D, et al. Clavicle fractures: a comparison of five classification systems and their relationship to treatment outcomes. Int Orthop, 2011, 35(6): 909-914.
6. Rockwood CA Jr, Groh GI, Wirth MA, et al. Resection arthroplasty of the sternoclavicular joint. J Bone Joint Surg (Am), 1997, 79(3): 387-393.
7. Stillwell A, Ioannou C, Daniele L, et al. Osteosynthesis for clavicle fractures: How close are we to penetration of neurovascular structures? Injury, 2017, 48(2): 460-463.
8. Wang Y, Jiang J, Dou B, et al. Inverted distal clavicle anatomic locking plate for displaced medial clavicle fracture. Arch Orthop Trauma Surg, 2015, 135(9): 1241-1245.
9. Robinson L, Persico F, Lorenz E, et al. Clavicular caution: an anatomic study of neurovascular structures. Injury, 2014, 45(12): 1867-1869.
10. Clitherow HD, Bain GI. Association between screw prominence and vascular complications after clavicle fixation. Int J Shoulder Surg, 2014, 8(4): 122-126.
11. Ding M, Hu J, Ni J, et al. Iatrogenic subclavian arteriovenous fistula: rare complication of plate osteosynthesis of clavicle fracture. Orthopedics, 2012, 35(2): e287-e289.
12. Sidhu VS, Hermans D, Duckworth DG. The operative outcomes of displaced medial-end clavicle fractures. J Shoulder Elbow Surg, 2015, 24(11): 1728-1734.
13. Bartonícek J, Fric V, Pacovsky V. Displaced fractures of the medial end of the clavicle: report of five cases. J Orthop Trauma, 2010, 24(4): e31-e35.
14. Fransen P, Bourgeois S, Rommens J. Kirschner wire migration causing spinal cord injury one year after internal fixation of a clavicle fracture. Acta Orthop Belg, 2007, 73(3): 390-392.
15. Gille J, Schulz A, Wallstabe S, et al. Hook plate for medial clavicle fracture. Indian J Orthop, 2010, 44(2): 221-223.
16. 稅巍, 張喜海, 陽運康, 等. T 型鎖定鋼板內固定治療鎖骨內側端骨折的臨床療效. 中國修復重建外科雜志, 2010, 24(8): 897-899.
17. Kim KC, Shin HD, Cha SM. Surgical treatment of displaced medial clavicle fractures using a small T-shaped plate and tension band sutures. Arch Orthop Trauma Surg, 2011, 131(12): 1673-1676.
18. 楊琨, 陽運康, 葛建華, 等. 胸鎖關節解剖鎖定鋼板的研制及生物力學研究. 中國修復重建外科雜志, 2018, 32(1): 7-13.
19. Alajmo G, Schlegel U, Gueorguiev B, et al. Plunging when drilling: effect of using blunt drill bits. J Orthop Trauma, 2012, 26(8): 482-487.
20. 孫遠林, 陽運康, 葛建華, 等. 新型胸鎖關節解剖鎖定鋼板的研制與臨床應用. 中國修復重建外科雜志, 2018, 32(3): 316-321.

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Effectiveness analysis of distal radius microplate locking plate for treatment of displaced fracture of medial clavicle

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