Lateral Clavicle Fracture Fixation Using a Superiorly Placed Locking Plate.
Edmund Ieong1, Nicholas Antonio Ferran1
1Department of Trauma and Orthopaedics, London North West Healthcare NHS Trust, Northwick Park Hospital, Harrow, United Kingdom.
JBJS Essential Surgical Techniques
|September 21, 2018
Summary
Displaced lateral clavicle fractures can lead to nonunion. This study details a surgical technique using a compression plate, achieving high union rates and good functional outcomes for these challenging clavicle fractures.
Area of Science:
- Orthopedic Surgery
- Traumatology
- Biomedical Engineering
Background:
- Lateral clavicle fractures constitute 21% of all clavicle fractures.
- Displaced fractures with coracoclavicular ligament disruption have high nonunion rates (up to 28%).
- Advancements in fixation include superiorly placed locking plates for specific fracture types.
Purpose of the Study:
- To describe a surgical technique for fixation of unstable, displaced lateral clavicle fractures using a compression plate.
- To highlight the steps involved in achieving stable fixation and promoting union.
Main Methods:
- Fracture pattern identification and surgical planning.
- Operating room setup with image intensifier optimization.
- Bra-strap incision, fracture reduction, and temporary stabilization.
- Implant selection and fixation with bicortical and locking screws.
- Layered closure, postoperative care, and physiotherapy.
Main Results:
- The described technique aims for high union rates in lateral clavicle fractures.
- Good-to-excellent functional outcomes are demonstrated in studies.
- The combined complication rate is approximately 6%.
Conclusions:
- Compression plate fixation is an effective method for unstable lateral clavicle fractures.
- The technique offers a viable surgical option with favorable outcomes.
- Careful planning and execution are crucial for successful treatment.
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