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.	吴晓明, 李凡, 高伟, 等. 胸锁关节外锁骨近端骨折的治疗. 中华创伤骨科杂志, 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, Pacovský 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.	税巍, 张喜海, 阳运康, 等. T 型锁定钢板内固定治疗锁骨内侧端骨折的临床疗效. 中国修复重建外科杂志, 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.	杨琨, 阳运康, 葛建华, 等. 胸锁关节解剖锁定钢板的研制及生物力学研究. 中国修复重建外科杂志, 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.	孙远林, 阳运康, 葛建华, 等. 新型胸锁关节解剖锁定钢板的研制与临床应用. 中国修复重建外科杂志, 2018, 32(3): 316-321.

1. 吴晓明, 李凡, 高伟, 等. 胸锁关节外锁骨近端骨折的治疗. 中华创伤骨科杂志, 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, Pacovský 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. 税巍, 张喜海, 阳运康, 等. T 型锁定钢板内固定治疗锁骨内侧端骨折的临床疗效. 中国修复重建外科杂志, 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. 杨琨, 阳运康, 葛建华, 等. 胸锁关节解剖锁定钢板的研制及生物力学研究. 中国修复重建外科杂志, 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. 孙远林, 阳运康, 葛建华, 等. 新型胸锁关节解剖锁定钢板的研制与临床应用. 中国修复重建外科杂志, 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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