Surgical treatment of unstable and displaced medial clavicle fractures with a contoured biplanar low profile angle stable implant.

IF 1 4区医学 Q3 ORTHOPEDICS

Operative Orthopadie Und Traumatologie Pub Date : 2025-05-22 DOI:10.1007/s00064-025-00901-0

J Schmalzl, J Zimmermann, L Hufnagel, R Meffert

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引用次数: 0

Abstract

Objective: To achieve stable fixation to allow early mobilization by using a low profile contoured biplanar implant to avoid soft tissue problems and to minimize need for implant removal.

Indications: Unstable and displaced medial clavicle fractures in young patients with high functional demands.

Contraindications: Open/contaminated fractures. Fractures in geriatric patients with low functional demands.

Surgical technique: Saber cut incision over the medial clavicle. Perpendicular incision to open the calvipectoral fascia. Fracture reduction and temporary retention. Contouring and attachment of the plate. Definitive plate fixation. Radiological documentation.

Postoperative management: Cryotherapy, anti-inflammatory medication on demand. Shoulder sling for comfort for 1-2 weeks. Physical therapy with active flexion and abduction limited to 90° for 6 weeks. Clinical and radiological follow up for 6-12 months.

Results: In total, 5 patients were treated with the described technique. All patients were very satisfied with the result. The mean Constant-Murley score was 91 points and the mean Quick DASH (disabilities of shoulder and hand) was 3% after an average follow-up of 74 months. In none of the cases implant removal was necessary.

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轮廓双平面低轮廓角稳定植入物治疗不稳定和移位的内侧锁骨骨折。

目的：通过使用低轮廓双面种植体实现稳定的固定，以允许早期活动，避免软组织问题，并最大限度地减少种植体移除的需要。适应症：年轻患者锁骨内侧骨折不稳定和移位，功能要求高。禁忌症：开放性/污染骨折。功能需求低的老年患者骨折。手术技术：在锁骨内侧切开刀口。垂直切口打开胸筋膜。骨折复位和暂时保留。印版的轮廓和附著。明确钢板固定。放射文档。术后处理：冷冻治疗，按需消炎药。肩带舒适1-2周。主动屈曲和外展限制在90°的物理治疗6周。临床及影像学随访6-12个月。结果：采用上述方法治疗5例患者。所有患者对治疗结果都非常满意。平均随访74个月后，平均Constant-Murley评分为91分，平均Quick DASH（肩部和手部残疾）为3%。在所有病例中，不需要移除种植体。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Operative Orthopadie Und Traumatologie ORTHOPEDICS-

CiteScore

2.10

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Orthopedics and Traumatology is directed toward all orthopedic surgeons, trauma-tologists, hand surgeons, specialists in sports injuries, orthopedics and rheumatology as well as gene-al surgeons who require access to reliable information on current operative methods to ensure the quality of patient advice, preoperative planning, and postoperative care. The journal presents established and new operative procedures in uniformly structured and extensively illustrated contributions. All aspects are presented step-by-step from indications, contraindications, patient education, and preparation of the operation right through to postoperative care. The advantages and disadvantages, possible complications, deficiencies and risks of the methods as well as significant results with their evaluation criteria are discussed. To allow the reader to assess the outcome, results are detailed and based on internationally recognized scoring systems. Orthopedics and Traumatology facilitates effective advancement and further education for all those active in both special and conservative fields of orthopedics, traumatology, and general surgery, offers sup-port for therapeutic decision-making, and provides – more than 30 years after its first publication – constantly expanding and up-to-date teaching on operative techniques.