Kyeong-Seop Song; Hyung-Gyu Kim; Byeong-Mun Park; Jong-Min Kim; Sung-Hoon Jung; Bong-Seok Yang

doi:10.12671/jkfs.2009.22.1.24

Articles

Page Path: HOME > J Musculoskelet Trauma > Volume 22(1); 2009 > Article

Original Article
Double Tension Band Wire Fixation for Unstable Fracture of the Distal Clavicle: Kyeong-Seop Song, M.D., Hyung-Gyu Kim, M.D., Byeong-Mun Park, M.D., Jong-Min Kim, M.D., Sung-Hoon Jung, M.D., Bong-Seok Yang, M.D.; Journal of the Korean Fracture Society 2009;22(1):24-29.
DOI: https://doi.org/10.12671/jkfs.2009.22.1.24
Published online: January 31, 2009

Department of Orthopaedic Surgery, Kwangmyung Sung-Ae Hospital, Gwangmyeong, Korea.

Address reprint requests to: Hyung-Gyu Kim, M.D. Department of Orthopedic Surgery, Kwangmyung Sung-Ae Hospital, 389, Chulsan 3-dong, Gwangmyung 423-711, Korea. Tel: 82-2-2680-7236, Fax: 82-2-2617-9039, khg0623@hanmail.net

• Received: October 11, 2008 • Accepted: November 10, 2008

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

81 Views
1 Download

prev next

Full Article

Download PDF

Abstract
REFERENCES

Abstract

Purpose
To evaluate the clinical results after operative treatment with the double tension band wire fixation in Neer type II and III distal clavicle fractures.
Materials and Methods
Ten patients with type II and III distal clavicle fractures were evaluated, who operated with double tension band wire fixation technique, from Febrary 2007 to June 2008, and could be followed-up for more than 1 year after operation. Postoperative assessments were evaluated on plain x-ray, pain, and clinical finding according to the functional criteria by Kona et al.
Results
Average duration from operation to fracture union was 8 weeks in all cases. There were 8 excellent and 2 good results. It was no other significant complications such as K-wire migration, breakage, infection, and AC joint arthritis.
Conclusion
Double tension band wire fixation technique seems to be an effective method for type II or III distal clavicle fracture with multiple compressive axis, without injury of the AC joint and loosening of the fixation.
Key words: Distal clavicle fracture, Double tension band wire fixation

REFERENCES

1. Caspi I, Ezra E, Oliver S, Lin E, Horoszowski H. Treament of Avulsed calvicle and recurrent subluxation of the ipsilateral shoulder by dynamic fixation. J Trauma, 1987;27:94-95.
2. Chun JM, Kim SY, Lee KW, Shin SJ, Kim EG. Modified tension band fixation for unstable fracture of the distal clavicle. J Korean Orthop Assoc, 2002;37:416-420.Article PDF
3. Craig EV. Fracture of the distal clavicle. In: Rockwood CA, Matsen FA, editors. The shoulder. Philadelphia, WB: Sauders; 1990. p. 367-412.
4. Edwards DJ, Kavanagh TG, Flannery MC. Fractures of the distal clavicle: a case for fixation. Injury, 1992;23:44-46.
5. Flinkkilä T, Ristiniemi J, Hyvönen P, Hämäläinen M. Surgical treatment of unstable fractures of the distal clavicle: a comparative study of Kirschner wire and clavicular hook plate fixation. Acta Orthop Scand, 2002;73:50-53.Article
6. Goldberg JA, Bruce WM, Sonnabend DH, Walsh WR. Type 2 fractures of the distal clavicle: a new surgical technique. J Shoulder Elbow Surg, 1997;6:380-382.Article
7. Hessmann M, Kirschner R, Baumgatel F, Gehling H, Gotzen L. Treatment of unstable distal clavicular fractures with and without lesions of the acromioclavicular joint. Injury, 1996;27:47-52.Article
8. Kang HJ, Park KK, Yoon HK, Song HK, Hahn SB. T plate fixation for unstable frature of distal clavicle. J Korean Fract Soc, 2006;19:329-334.
9. Kao FC, Chao EK, Chen CH, Yu SW, Chen CY, Yen CY. Treatment of distal clavicle fracture using Kirschner wires and tension-band wires. J Trauma, 2001;51:522-525.Article
10. Katznelson A, Nerubay J, Oliver S. Dynamic fixation of the avulsed clavicle. J Trauma, 1976;16:841-844.Article
11. Kona J, Bosse MJ, Staeheli JW, Rosseau RL. Type II distal clavicle fracture: a retrospective review of surgical treatment. J Orthop Trauma, 1990;4:115-120.
12. Lyons FA, Rockwood CA Jr. Migration of pins used in operations on the shoulder. J Bone Joint Surg Am, 1990;72:1262-1267.
13. Moneim MS, Balduini FC. Coracoid fracture as a complication of surgical treatment by coracoclavicular tape fixation. A case report. Clin Orthop Relat Res, 1982;168:133-135.
14. Neer CS II. Fracture of the distal third of the clavicle. Clin Orthop Relat Res, 1968;58:43-50.
15. Neviaser RJ. Injuries to the clavicle and acromioclavicular joint. Orthop Clin North Am, 1987;18:433-438.Article
16. Nordqvist A, Petersson C, Redlund-Johnell I. The natural course of lateral clavicle fracture: 15(11~21) year follow-up of 110 cases. Acta Orthop Scand, 1993;64:87-91.
17. Parkes JC, Deland JT. A three-part distal clavicle fracture. J Trauma, 1983;23:437-438.Article
18. Park JH, Rha KW, Suh SW, Kim SK. Operative treatment of type 2 distal clavicle fractures. J Korean Fracture Soc, 1998;11:683-689.
19. Post M. Current concepts in the treatment of fractures of the clavicle. Clin Orthop Relat Res, 1989;245:89-101.Article
20. Rockwood CA. Fracture of the outer clavicle in children and adults. Orthop Trans, 1982;6:472.
21. Yamaguchi H, Arakawa H, Kobayashi M. Results of the Bosworth method for unstable fractures of the distal clavicle. Int Orthop, 1998;22:366-368.Article PDF

Fig. 1

Illustrations of the surgical technique of double tension band wire fixation for distal clavicle.

(A) Insertion two K-wires from distal to proximal and one K-wire from anteior to posterior for typical tension band wire fixation.

(B) Insertion of one more K-wire from anterior to posterior at distal fragment and another tension band wire fixation over the fracture site.

Fig. 2

A demonstration model of the double tension band wire fixation.

Fig. 3

A 32-years-old male was injured by traffic accident.

(A) The radiograph shows a type IIb unstable distal clavicle fracture with a long transverse fragment.

(B) The fracture is fixed with double tension band wire and additional two circular wires.

(C) After removal of the implats at postoperative 14 months, complete union of the fracture site is seen.

Fig. 4

A 17-years-old female was injured by slip down.

(A) The radiograph shows a type IIb unstable distal clavicle fracture.

(B) Postoperative radiograph shows the fracture fixed with double tension band wire.

(C) Fracture is united in 6 weeks after surgery on radiograph.

Table 1

Demographic data of the patients

^*Double tension band wire, ^†Circular wire.

Table 2

Classification of functional results by Kona et al.

Figure & Data

REFERENCES

Citations

Citations to this article as recorded by

Cite

CITE: export Copy Download Format; Close

Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

Format:

RIS — For EndNote, ProCite, RefWorks, and most other reference management software
BibTeX — For JabRef, BibDesk, and other BibTeX-specific software

Include:

Citation for the content below
Citation and abstract for the content below

Double Tension Band Wire Fixation for Unstable Fracture of the Distal Clavicle

J Korean Fract Soc. 2009;22(1):24-29. Published online January 31, 2009

DOI: https://doi.org/10.12671/jkfs.2009.22.1.24

XML Download

Figure

We recommend

Double Tension Band Wire Fixation for Unstable Fracture of the Distal Clavicle

Fig. 1 Illustrations of the surgical technique of double tension band wire fixation for distal clavicle. (A) Insertion two K-wires from distal to proximal and one K-wire from anteior to posterior for typical tension band wire fixation. (B) Insertion of one more K-wire from anterior to posterior at distal fragment and another tension band wire fixation over the fracture site.

Fig. 2 A demonstration model of the double tension band wire fixation.

Fig. 3 A 32-years-old male was injured by traffic accident. (A) The radiograph shows a type IIb unstable distal clavicle fracture with a long transverse fragment. (B) The fracture is fixed with double tension band wire and additional two circular wires. (C) After removal of the implats at postoperative 14 months, complete union of the fracture site is seen.

Fig. 4 A 17-years-old female was injured by slip down. (A) The radiograph shows a type IIb unstable distal clavicle fracture. (B) Postoperative radiograph shows the fracture fixed with double tension band wire. (C) Fracture is united in 6 weeks after surgery on radiograph.

Fig. 1

Fig. 2

Fig. 3

Fig. 4

Double Tension Band Wire Fixation for Unstable Fracture of the Distal Clavicle

Table 1

Demographic data of the patients

^*Double tension band wire, ^†Circular wire.

Table 2

Classification of functional results by Kona et al.

Table 1 Demographic data of the patients

^*Double tension band wire, ^†Circular wire.

Table 2 Classification of functional results by Kona et al.