Surgical Management of Fractures of the Lateral Third of the Clavicle

Ahmad Sh Saad, A.^*, Khaled Hafez, M. A. & Sanad Mousa Younes, M.

Orthopaedic Surgeon at Canheal Clini, Egypt

Dr. Ahmad Sh Saad, A., Orthopaedic Surgeon at Canheal Clini, Egypt.

Keywords: Fracture Distal Clavicle; Intra Articular Fixation; Kirschner (K) Wire; Reconstruction Plate

Abstract

Objective
To evaluate the results of fixation of fractures of lateral third clavicle by two types of surgical procedures.
Methods
Twenty patients with a Neer type II fracture lateral third clavicle were treated surgically, eleven of them with intra-articular Kirschner (K) wires and seven cases with 3.5mm unlocked reconstruction plate in the period between April to July 2017. The other two cases were excluded as they did not attend the follow up regularly. All patients were reviewed clinically, radiologically, and with Constant Shoulder Scoring System. Both Complications and return to previous activity were also assessed for all patients at the end of follow-up.
Results
Eighteen patients were followed up for an average of 7.5 months (range 6-9) months. All the fractures had radiological bony union at mean time of 8.6 weeks for Plate group and 8.5 weeks for K wires group. The mean Constant shoulder score of the operated side was 93.3 points for plate group, which was comparable to the K wire group (91.1) (P = 0.68). Regarding complications, there was one case of case of painful shoulder and another case of superficial infection in Plate group. In the K wires group there were one case of one case of nonunion, 2 cases of painful shoulder and 2 cases of superficial infection. In plate group all cases returned to their previous work, while in K wires group 2 cases did not attend their previous work.

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