Mid-third clavicle fracture combined with acromioclavicular joint dislocation treated with double Endobutton plate plus clavicle plate

doi:10.3969/j.issn.2095-4344.2013.52.011

Abstract

Abstract:

BACKGROUND: Combination of mid-third clavicle fracture with acromioclavicular joint dislocation is a rare injury. The internal fixation treatment of this injury remains controversial.
OBJECTIVE: To investigate the treatment of a rare injury of mid-third clavicle fracture combined with acromioclavicular joint dislocation.
METHODS: Three patients with mid-third clavicle fracture with acromioclavicular joint dislocation from 2005 to 2011 were analyzed retrospectively. The three patients were treated with clavicle anatomic locking plate+wire subcoracoid cerclage, clavicle anatomic locking plate+clavicular hook plate and clavicle anatomic locking plate+dual Endobutton plate coracoclavicular ligament reconstruction, respectively. The treatment effects of these three methods were compared, including the operation time, blood loss, and the shoulder function evaluation.
RESULTS AND CONCLUSION: One case was misdiagnosed as simple mid-third clavicle fracture. All the three patients were followed-up for more than 12 months, and the clavicle fracture healed in all three cases. The internal fixators were moved out at 12, 9 and 11 months, the Endobutton plate was still in the body, and no redislocation happened in all cases. The pain, daily function, activity and muscle strength were compressively assessed before and after internal fixator removal. The scores of the three patients were 64, 71 and 92 before surgery, and 68, 79 and 95 after surgery. Patient treated with double Endobutton and locking plate had the best recovery. Double Endobutton plus clavicle plate are good choice as internal fixation in the treatment of mid-third clavicle fracture combined with acromioclavicular joint dislocation.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

全文链接：

Key words: clavicle, fractures, bone, acromioclavicular joint, internal fixators

CLC Number:

R318

Chen Yu, Song Xuan, Yu Si-ming. Mid-third clavicle fracture combined with acromioclavicular joint dislocation treated with double Endobutton plate plus clavicle plate[J]. Chinese Journal of Tissue Engineering Research, 2013, 17(52): 9005-9010.

Figures/Tables 2

References

[1] 胥少汀,葛宝丰,徐印坎.实用骨科学[M].北京:人民军医出版社, 2008: 397 .

[2] 王亦璁,王继懋,郭子恒.骨与关节损伤[M].北京:人民卫生出版社, 1999.

[3] Heinz WM, Misamore GW. Mid-shaft fracture of the clavicle with grade III acromioclavicular separation. J Shoulder Elbow Surg. 1995;4(2): 141-142.

[4] Lancourt JE. Acromioclavicular dislocation with adjacent clavicular fracture in a horseback rider. A case report. Am J Sports Med. 1990;18(3): 321.

[5] Wisniewski TF. Posterior acromioclavicular dislocation with clavicular fracture and trapezius entrapment. Europ J Trauma. 2004; 30(2): 120-123.

[6] Wurtz LD, Lyons FA, Rockwood Jr CA. Fracture of the middle third of the clavicle and dislocation of the acromioclavicular joint. A report of four cases. J Bone Joint Surg Am. 1992;74(1): 133.

[7] Yeh PC, Miller SR, Cunningham JG, et al. Midshaft clavicle fracture and acromioclavicular dislocation: a case report of a rare injury. J Shoulder Elbow Surg. 2009;18(5): e1-e4.

[8] Psarakis SA, Savvidou OD, Voyaki SM, et al. A rare injury of ipsilateral mid-third clavicle fracture with acromioclavicular joint dislocation. Hand. 2011;6(2): 228-232.

[9] 王照平.锁骨中外1/3骨折合并肩锁关节脱位漏诊1例报告[J].实用骨科杂志,2011,17(8):762-763.

[10] 许猛,张群,唐佩福,等.锁骨中段骨折合并肩锁关节脱位1例[J]. 人民军医,2008,51(5):325-325.

[11] 鲍飞龙,张燕,高伟,等.肩锁关节脱位并锁骨骨折1例[J].中医正骨, 2005,18(1): 77-77.

[12] 王刚,李强,申屠刚,等.临床较少见的锁骨骨折伴肩锁关节全脱位[J].临床误诊误治, 2010, 23(4): 337-337.

[13] 肖奕增,吕宏升,郑文忠.锁骨中段骨折伴肩锁关节脱位漏诊1例[J]. 中国误诊学杂志, 2011,11(17):4110.

[14] 盛奎升,王瑞国,魏书俊,等.锁骨中段骨折合并肩锁关节脱位漏诊3例补救分析[J].中国误诊学杂志, 2010, 10(1):100-101.

[15] 罗晓明,王宁.锁骨中段骨折并同侧肩锁关节脱位1例[J].实用骨科杂志,2012,18(7):669-669.

[16] 吴金全,程华,张述东.锁骨中段骨折并肩锁关节脱位治疗体会[J]. 青岛医药卫生, 2009, 41(3):198-199.

[17] Sanders JO, Lyons FA, Rockwood Jr CA. Management of dislocations of both ends of the clavicle. J Bone Joint Surg. 1990;72(3): 399.

[18] Constant CR, Murley AG. A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res.1987;214: 160-164.

[19] Tossy JD, Mead NC, Sigmond HM. Acromioclavicular Separations: Useful and Practical Classification for Treatment. Clin Orthop Relat Res. 1963;28: 111-119.

[20] Urist MR. Complete dislocations of the acromiclavicular joint; the nature of the traumatic lesion and effective methods of treatment with an analysis of forty-one cases. J Bone Joint Surg. 1946;28(4): 813-837.

[21] Law KY, Yung SH, Ho PY, et al. Coracoclavicular ligament reconstruction using a gracilis tendon graft for acute type-III acromioclavicular dislocation. J Orthop Surg (Hong Kong). 2007;15(3): 315.

[22] 陆叶,陈云丰.肩锁关节脱位手术治疗中修复重建方式及修复材料的临床应用研究与进展[J].中国组织工程研究与临床康复, 2009, 13(42): 8341-8345.

[23] Li BC, Zhang M, Shi D, et al. Postoperative complications of acromioclavicular joint dislocation of Tossy III. Zhongguo gu shang. 2009;22(2): 95.

[24] Lee YS, Lau MJ, Tseng YC, et al. Comparison of the efficacy of hook plate versus tension band wire in the treatment of unstable fractures of the distal clavicle. Int Orthop.2009; 33(5): 1401-1405.

[25] Ejam S, Lind T, Falkenberg B. Surgical treatment of acute and chronic acromioclavicular dislocation Tossy type III and V using the Hook plate. Acta Orthopaedica Belgica. 2008;74(4): 441.

[26] Woolf SK, Valentine BJ, Barfield WR, et al. Middle-Third Clavicle Fracture With Associated Type IV Acromioclavicular Separation: Case Report and Literature Review. J Surg Orthop Adv. 2013;22(2): 183-186.

[27] 许本柯,舒先涛,周文明,等.锁骨解剖观察及临床意义[J].解剖学研究, 2001, 23(3): 224-226.

[28] Struhl S. Double endobutton technique for repair of complete acromioclavicular joint dislocations. Techniq Shoulder Elbow Surg. 2007;8(4): 175-179.