Treatment of distal clavicle fracture using Kirschner wires and tension-band wires

Kao, FC Chao, EK Chen, CH Yu, SW Chen, CY Yen, CY

Fc. Kao et al., Treatment of distal clavicle fracture using Kirschner wires and tension-band wires, J TRAUMA, 51(3), 2001, pp. 522-525

16

INGLESE

Article

Aneshtesia & Intensive Care

JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE → ACNP

51

3

2001

522 - 525

ISI

Background: Nonunion frequently follows distal clavicle fracture. Tradition al pinning methods using the through acromioclavicular articulation may res ult in osteoarthritic changes or ankylosis. This study introduces a direct pinning technique in which the acromioclavicular joint is spared. Methods: Twelve patients with displaced distal clavicle fractures received open reduction and fixation with Kirschner wires (K-wires) and tension-band wires, from May 1996 to March 1997. The indication for surgery was type Il a fracture or fracture with displacement. Unrestricted passive and active r ange of motion was performed as soon as possible after the operation. Stret ching and exertional exercises were permitted after radiographs showed an o sseous union and after the implants were removed. Results: Eleven patients achieved osseous union with painless full motion. Union time ranged from 3 to 6 months. One patient suffered from more commin uted fracture because of a fall 2 months after operation. This patient rece ived a revision surgery with distal clavicle resection and coracoclavicle r econstruction. Symptomless ossification around the coracoclavicle ligament was noted on radiographs in one patient. The ossification did not progress after the 9-month follow-up. Conclusion. Edwards reported a rate of 45% delayed union and 30% nonunion i n type II fractures. Several techniques had been described in the relevant literature. In our practice, fixation with Kirschner wires and tension-band wires has been successful in the treatment for displaced distal clavicle f racture.