T-plate fixation for unstable proximal clavicula fractures

Özet

Objective: The aim of this study was to evaluate the clinical results of T-plate fixation and anteriorsternoclavicular ligament repair in proximal clavicle fractures.Methods: Between August 2013 and August 2016, a total 12 patients (10 men and 2 women; mean age:44.1 ± 9.1 years (range, 25e59 years)) with unstable proximal clavicle fractures (Throckmorton, type D)were treated with T-type plate fixation, bridging the sternoclavicular joint, and anterior sternoclavicularligament repair. Average operative time, associated injuries, postoperative complications, postoperativefracture healing time and follow-up time were recorded. The outcomes were evaluated with radiographicassessment, visual analog scale (VAS) pain score and Rockwood SCJ scoring system. All the patients wereevaluated on postoperative 3rd, 6th, and 12th months.Results: The average surgery time was 78.0 ± 8.47 minutes while fracture healing time was 4.51 ± 0.95months. According to Rockwood SCJ scoring system, 9 cases (75%) were in excellent, 2 cases (16.7%) ingood and 1 case (8.3%) in fair condition at 12 months follow-up. The average Rockwood SCJ score was7.7 ± 0.75 preoperatively, 12.7 ± 0.86 by 3 months, 13.0 ± 0.73 by 6 months and 13.3 ± 0.49 by 12 months.The VAS pain score was 7.9 ± 1.15 (preoperative score), 3.4 ± 1.52 (3 months follow-up), 3.0 ± 1.32 (6months follow-up) and 2.1 ± 1.07 (12 months follow-up). The VAS and Rockwood SCJ scores weresignificantly improved postoperatively (p < 0.05). There was no intraoperative complication, while onepatient had redislocation of the sternoclavicular joint after implant removal.Conclusion: T-type plate fixation with anterior sternoclavicular ligament repair might be a reliable andeffective treatment method in unstable proximal clavicle fractures (type D) with few complications andsatisfactory clinical results after 12 months follow-up.