[An alternative fixation method for the treatment of unstable distal clavicle fractures: locked distal radius plate]

Optimal surgical fixation method for displaced distal clavicle fractures should not impose limitations on neighboring joint movements. We evaluated the results of surgical treatment of displaced distal clavicle fractures using locked distal radius plates.

Displaced distal clavicle fractures of 14 consecutive patients (11 men, 3 women; mean age 30 + or - 9 years; range 19 to 51 years) were treated using open reduction and locked distal radius plates. Before final fixation, one patient underwent K-wire fixation with tension band at another center, resulting in nonunion. Except for two cases with late presentation, the mean time to surgery was 5.3 days (range 1 to 17 days). According to the Neer classification, fresh fractures were type II in 10 patients and type III in three patients. Shoulder examinations and functional evaluations were made at 3, 6, and 12 months postoperatively. Functional assessment included the Modified Shoulder Rating Scale and Constant score.

All patients achieved full range of motion of the shoulder at six weeks postoperatively. The mean modified shoulder score was 18.7 + or - 1.5 and the mean Constant score was 95.4 + or - 3.0 at 12 months. None of the patients developed implant failure, loss of reduction, skin breakdown, or infection.

In selected acute fractures and nonunions of the distal clavicle, excellent clinical results are easily achievable with locked distal radius plate fixation because it allows early shoulder movements without necessitating implant removal.