Hanflik Andrew, Hanypsiak Bryan T, Greenspoon Joshua, Friedman Darren J
Department of Orthopaedic Surgery, Kingsbrook Jewish Medical Center, Brooklyn, New York, U.S.A.
Arthrex, Naples, Florida, U.S.A.
Arthrosc Tech. 2014 Sep 1;3(5):e551-4. doi: 10.1016/j.eats.2014.05.012. eCollection 2014 Oct.
Distal clavicle fractures are common, and no standard treatment exists. Many different surgical modalities exist. This report describes an open reduction internal fixation technique that achieves both plate and coracoclavicular stabilization using a button device. A precontoured superior-lateral plate is secured to the clavicle. A 3.2-mm spade-tipped drill bit is drilled across the clavicle and coracoid, passing through 4 cortices. The button is loaded onto an insertion device, passed across the 4 cortices, and captured on the undersurface of the coracoid under fluoroscopic guidance. This construct is linked to the distal clavicle plate by heavy sutures using a second button that sits in the plate. The lateral locking holes are then filled to finalize fixation. This technique provides for a simplified way to achieve coracoclavicular stabilization when using a plate for fixation of distal clavicle fractures.
锁骨远端骨折很常见，目前尚无标准治疗方法。存在许多不同的手术方式。本报告描述了一种切开复位内固定技术，该技术使用纽扣装置实现钢板固定和喙锁固定。将预塑形的上外侧钢板固定于锁骨。使用3.2毫米铲形钻头钻透锁骨和喙突，穿过4层皮质。将纽扣装载到插入装置上，穿过4层皮质，并在透视引导下固定于喙突下表面。使用位于钢板内的第二个纽扣通过粗缝线将该结构与锁骨远端钢板相连。然后填充外侧锁定孔以完成固定。当使用钢板固定锁骨远端骨折时，该技术提供了一种实现喙锁固定的简化方法。
