Campbell Benjamin R, Petrucelli Philip M, Kearns Kenneth A
Department of Orthopaedic Surgery, The Rothman Institute at Thomas Jefferson University, Philadelphia, PA, USA.
Department of Orthopaedic Surgery, Philadelphia Hand to Shoulder Center at Thomas Jefferson University, Philadelphia, PA, USA.
JSES Rev Rep Tech. 2024 Mar 16;4(3):393-397. doi: 10.1016/j.xrrt.2024.02.003. eCollection 2024 Aug.
Distal one-third clavicle fractures are frequently unstable and often require surgical fixation due to high rates of nonunion. Many common methods of fixation have high rates of union but are associated with hardware discomfort and need for secondary surgery. The purpose of this study was to evaluate the outcomes of a fixation technique involving arthroscopically assisted open reduction internal fixation of unstable distal clavicle fractures via a coracoclavicular (CC) suspensory endobutton and cerclage tape.
This was a retrospective case series evaluating patients who underwent fixation of unstable distal clavicle fractures via arthroscopically assisted CC stabilization by a single fellowship-trained shoulder and elbow surgeon between 2020 and 2022. Demographic and injury-related data were collected via chart review. Preoperative and postoperative radiographs were reviewed to evaluate for signs of radiographic union. Primary outcome measures included fracture union, complications, and need for additional procedures. Patients were also contacted via telephone to obtain American Shoulder and Elbow Surgeons scores.
Six patients were eligible for inclusion in this study with a mean age of 52.8 ± 14.0 and a mean follow-up of 2.0 years (range 1.6-2.7 years). Mean American Shoulder and Elbow Surgeons scores were 86.2 ± 21.8 (range 52-100). There were no postoperative complications, signs of symptomatic hardware, or need for secondary surgery at the final follow-up among this cohort of patients. All patients had achieved and maintained full radiographic union at a mean radiographic follow-up of 5.5 months (range 2.0-12.9 months).
Arthroscopically assisted CC stabilization of distal clavicle fractures demonstrated high union rates while limiting complications or need for secondary hardware removal. Further analysis on a larger scale is recommended to determine long-term outcomes and direct comparison to other surgical techniques.
锁骨远端三分之一骨折通常不稳定，由于不愈合率高，常常需要手术固定。许多常见的固定方法愈合率高，但与内植物不适以及二次手术需求相关。本研究的目的是评估一种固定技术的疗效，该技术通过喙锁（CC）悬吊纽扣钢板和环扎带进行关节镜辅助下不稳定锁骨远端骨折切开复位内固定。
这是一项回顾性病例系列研究，评估了2020年至2022年间由一位接受过 fellowship 培训的肩肘外科医生通过关节镜辅助CC稳定术治疗不稳定锁骨远端骨折的患者。通过病历回顾收集人口统计学和损伤相关数据。复查术前和术后X线片以评估影像学愈合迹象。主要结局指标包括骨折愈合、并发症以及额外手术需求。还通过电话联系患者以获取美国肩肘外科医生评分。
6例患者符合本研究纳入标准，平均年龄52.8 ± 14.0岁，平均随访2.0年（范围1.6 - 2.7年）。美国肩肘外科医生平均评分为86.2 ± 21.8（范围52 - 100）。在该组患者的末次随访中，没有术后并发症、有症状的内植物迹象或二次手术需求。所有患者在平均影像学随访5.5个月（范围2.0 - 12.9个月）时均实现并维持了完全影像学愈合。
关节镜辅助下CC稳定锁骨远端骨折显示出高愈合率，同时限制了并发症或二次取出内植物的需求。建议进行更大规模的进一步分析以确定长期疗效并与其他手术技术进行直接比较。
