Journal of Musculoskeletal Trauma

Results of Hook Plate Fixation of Unstable Distal Clavicle Fractures: Hoon Sang Sohn, Byung Chul Jo; J Korean Fract Soc 2011;24(4):335-340. Published online October 31, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.4.335

Abstract PDF: PURPOSE
This study evaluated the clinical and radiological outcomes of unstable distal clavicular fractures treated with an AO Hook plate.
MATERIALS AND METHODS
From March 2009 to October 2010, sixteen patients with distal clavicular fractures underwent open plating using an AO Hook plate. The clinical outcomes were assessed by measuring the UCLA scores and KSS sores, and the radiological outcomes were evaluated using simple radiographs at the final follow-up.
RESULTS
Fracture union was obtained in all patients at an average of 13.9 weeks (range, 9~20 weeks). The UCLA scoring system showed excellent results in 9 cases and good results in 7. The average KSS scores of distal clavicular fractures were 95.5. At the final follow-up, subacromial osteolysis developed in 11 cases (68.7%) of whom 3 suffered from pain around the acromion. Other complications occurred in 4 patients: one had a fracture adjacent to the plate proximally, two had a stiff shoulder with subacromial impingement, and one had hypoesthesia around the surgical wound.
CONCLUSION
Unstable distal clavicular fractures treated with a Hook plate provided rigid fixation and satisfactory outcomes considering the high union rate. Nevertheless, potential postoperative complications related to morphometric properties of the plate should be considered.

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Late-onset Brachial Artery Occlusion caused by Subclavian Artery Stenosis after Clavicular Fracture: A Case Report: Chul Hyung Kang, Chul Hyun Cho, Sung Won Sohn, Ki Chul Bae, Hyung Tae Kim; J Korean Fract Soc 2006;19(4):494-496. Published online October 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.4.494

Although vascular injury after clavicular fracture is a extremely rare, it is a complication which is serious problem. Vascular injury associated with the fracture can be immediate or delayed. We report a case of late-onset brachial artery occlusion caused by subclavian artery stenosis with excessive scar tissue after open reduction and plate fixation for clavicular fracture and include a review of the literature.

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Bilateral Brachial Artery Disease Presenting with Features of Raynaud’s Phenomenon: A Case Report and Review of the Literature
Karan Seegobin, Brittany Lyons, Satish Maharaj, Cherisse Baldeo, Pramod Reddy, James Cunningham
Case Reports in Vascular Medicine.2017; 2017: 1. CrossRef
Delayed Brachial Artery Occlusion after Humeral Shaft Open Fracture - A Case Report -
Chul-Hyun Cho, Ki-Cheor Bae, Kyung-Jae Lee, Si-Wook Lee
Journal of the Korean Fracture Society.2012; 25(2): 146. CrossRef

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Conservative Treatment of the Displaced Clavicular Shaft Fracture in Multiple Injury: Hyun Dae Shin, Kwang Jin Rhee, Young Mo Kim, Se Min Woo, Ho Sup Song; J Korean Fract Soc 2004;17(4):333-337. Published online October 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.4.333

Abstract PDF: PURPOSE
To analyse the comparative clinical results between adults with multiple injury including the clavicular shaft fracture and only clavicular shaft fracture who had supportive care through retrospective aspect.
MATERIALS AND METHODS
We had 48 adult patients in this hospital with simple fracture and multiple injury including the clavicular shaft whom we were able to evaluate at least more than a year. 12 of 48 patients were with only clavicular shaft fracture and the rest of them were with multiple injury. We classified patients into two groups those who had fracture with displacement for group A (A1 for the cases with over 50% of fracture surface contact rate and A2 for less than 50% from the images of simple X-ray) and those who had comminuted fracture for B. We compared the time of bone union, nonunion rate of only clavicular fractures and multiple injury, clinical results for patients who had supportive care with retrospective aspect.
RESULTS
A1 (7 cases), A2 (4 cases), B (1 case) were prevalent in the group of only clavicular shaft fracture and A1 (8 cases) and A2 (16 cases) and B (12 cases) were prevalent in the group of multiple injury. For the cases with supportive care, we could find 1 nonunion case (8%) and 11 union cases on average 2.91 months in the group of only clavicular shaft fracture and 7 nonunion cases (19%) and 29 union cases on average 3.58 months in the group of multiple injury. The best clinical results had occurred in 8 cases (67%) of only clavicular shaft fracture group and 19 cases (53%) of multiple injury group. We could find out the union from all 8 nonunion cases that took operation afterward.
CONCLUSION
Although the choice of treatment of clavicular fracture is supportive care, but multiple injury including the clavicular fracture is a high-energy injury, so the possibility of comminuted and displacement is high, so that nonunion rate is high. The possibility of early surgery must be considered seriously.

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The Surgical Treatment of Distal Clavicle Fractures: Eun Sun Moon, Jong Wook Jung, Gwang Cheul Jeong; J Korean Soc Fract 2001;14(4):706-713. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.706

Abstract PDF: PURPOSE
To evaluate and analyze the clinical and radiological result of surgical treatment for distal clavicular fractures.
MATERIALS AND METHODS
From Jan. 1995 to May. 2000, eighteen cases of distal clavicle fractures were treated operatively. Among them, fifteen cases with more than 12 months follow-up were analyzed retrospectively. In Neer classification, type I was 1 case and 14 cases were type II. We performed closed reduction in 4 cases and open reduction in 11 cases. We treated with Steinman pin in I case, K-wires in 6 cases and coracoclavicular screw(Bosworth technique) in 6 cases. One case was treated with coracoclavicular screw due to screw loosening which was used in primary operation. Another case was treated by internal fixation with plate and K-wire due to delayed union after conservative treatment of segmental fracture. Mean follow up period was 18 months(12~62 months). Clinical results was evaluated by Kona s criteria.
RESULTS
Radiological evidence of solid union was detected within 10 weeks in 13 cases. Clinical results were satisfactory in 13 cases (excellent in 10 cases and good in 3 cases). In K-wire fixation, all six cases were demonstrated excellent result. In coracoclavicular screw fixation, four of six cases were excellent, one was good and one was fair. Poor result was noted in one case of Steinmann pin fixation due to nonunion and limitation of range of motion. SUMMARY: Surgical treatment of distal claviclular fracture would obtain satisfactory clinical result with early range of motion exercise and reduce the complications such as nonunion and sustained pain.

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Fracture of the Coracoid Process: Sung Ho Hahn, Bo Kyu Yang, Chi Hong Kim, Tae Won Ahn, Dong Hyun Kim; J Korean Soc Fract 1996;9(4):1085-1089. Published online October 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.4.1085

Abstract PDF: Fractures of the coracoid process arf rare and those associated with a complete acromioclavicular separation and clavicular shaft fracture are even more rare. The mechanism of injury may be by direct trauma or by avulsion when there is sudden and violent contraction of the biceps, corachobrachilalis, and pectoralis minor muscle. The fracture occurs most commonly through the base. Conservative treatment can produce good result. Unusually open reduction is indicated for marked displacement associating acromioclavicular dissociation or compiession of the brahial plexus. The authors report 2 cases of coracoid process fracture. one case combined with acromioclavicular separation and the other with fracture of clavicular mid shaft.

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Treatment of the Clavicle Fracture: Kwang Suk Lee, Jung Ho Park, Geol Choi; J Korean Soc Fract 1995;8(3):461-466. Published online July 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.3.461

Abstract PDF: The clavicular fractures occur frequently and are treated conservatively, usually. But things are trending toward operative treatment in displaced cases due to nonunion. From June 1984 to November 1993, 153 patients(156 cases) among 297 patients with the clavicular fractures were analysed at Department of orthopedic surgery, Korea university hospital. The brief summary of the observations are as follows: 1. among 156 cases, the right side were 72 cases, the left side were 84 cases and both were 3 patients. The most common cause of injury was the the traffic accident and the most frequent site of the fracture was middle one-third. 2. According to the Allmans classification, the fractures were classified in three groups. Group Iwere 113 cases, Group II were 28 cases and Croup III were 15 cases and the average age of each groups were individually 28.7 yeara,35.4 years and 41.4 years respectively. 3. The average duration of the radiological union of the conservative treatment were 9.8 weeks in Group I ,9.7 weeks in Group II and 10.3 weeks in Group III. And of the operative treatment were 10.1 weeks in Group I , 10.1 weeks in Group II and 9.9 weeks in Group III Any difference between the conservative and the operative treatment was not observed. 4. The complications were nonunion in 2 cases, delayed union in 2 cases and refracture in 1 case after conservative treatment, and nonunion in 2 cases, delayed union in 1 case, refracture in 1 case and superficial wound infection in 1 case after operative treatment.

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