This is a very common fracture that occurs in people of all ages, often related to sporting activity such as skiing and cycling. Divergent locking screws can also be used laterally. Surgical technique clavicle plate and screw system. Fixation of unstable type ii clavicle fractures with. Scanning a patient who has this device may result in patient injury. Between december 2004 and august 2010, we treated 68 patients with neer type iib distal clavicle fractures using single coracoclavicular. Department of orthopaedic surgery, the 175th hospital of pla the affiliated southeast hospital of xiamen university, orthopaedic trauma center of pla, zhangzhou, 363000, pr china. However, most techniques coracoacromial ligament transfer, hook plate. Clavicle hook plate fixation for displaced lateralthird clavicle.
We offer one of the worlds most comprehensive portfolios of orthopaedic products and services in the areas of joint reconstruction, trauma, spine, sports medicine, craniomaxillofacial, power tools and biomaterials. To our knowledge, this is the first report of arthroscopicassisted lcp clavicular hook plate fixation for unstable fractures of the lateral end of the clavicle. Clavicle fracture broken collarbone a broken collarbone is also known as a clavicle fracture. The clavicle plate button is intended for use with the clavicle plates for clavicle indications such as for the treatment of syndesmotic trauma, such as acromioclavicular. The clavicle may be stabilized either with fixation placed superiorly or anteriorly based. However, the need for surgical treatment remains controversial as nonunion seldom produces a poor functional outcome.
Comparison between lcp clavicle hook plate and tension. Novel hybrid hook locking plate fixation for neer type v distal clavicle. This helps create an improved environment for bone healing, accelerating the patients return to previous mobility and function. The stainless steel plates are low profile and precontoured with locking and nonlocking screw options in each plate. Surgical technique clavicle plating system loqteq acroplate 3. The system was designed to allow both intuitive fit, and intraoperative. Precontoured locking plate fixation for displaced lateral. This article reports on a technique to treat unstable type ii distal clavicle fractures using fracturespeci. The synthes locking compression plate lcp is part of a stainless steel and titanium plate and screw system that merges locking screw technology with conventional plating techniques. Surgical treatment for unstable distal clavicle fracture with. Using the plate with 15 mm hook depth, pass the hook under the acromion. Lin hy, wong pk, ho wp, chuang ty, liao ys, wong cc. The early results of revision surgery using a novel surgical technique.
Hook plate fixation of acute displaced lateral clavicle fractures. A synthes hook plate was used, with planned removal in four to six months following surgery figure 2a, b, figure 3a, b. Hook plate for medial clavicle fracture pubmed central pmc. Biomechanical analysis of implanted clavicle hook plates with. Early acromial erosion with the synthes hook plate. Open reduction and internal fixation of a distal clavicle fracture using a clavicle hook plate. Clavicle surgical techniquefor nota bene the technique description herein is made available to the healthcare professional to illustrate the authors suggested treatment for the uncomplicated procedure. The recommendations for treating medial clavicle fractures ranges from conservative treatment to surgical reconstruction. An optimal, standardized operative treatment has not been yet established because of the small number of cases. Since the plate shaft is anatomically precontoured 12. Clavicular hook plates are effective fixation devices for distal clavicle fractures and severe acromioclavicular joint dislocations. If there is difficulty lowering the plate shaft onto the clavicle, then the plate with 18 mm hook depth should be used.
The plate is then secured using locking or nonlocking screws. Open reduction and internal fixation of a distal clavicle fracture using. Use of the ao hookplate for treatment of unstable fractures. Surgical treatment for unstable distal clavicle fracture with micromovable and anatomical acromioclavicular plate. Hook plate fixation of acute displaced lateral clavicle. The clavicle plate and screw system is a comprehensive set of plates, screws, and instruments designed to treat midshaft and distal clavicle fractures.
The patients were operated in beach chair position under general anaesthesia with the arm on the affected side, freely moveable. The fracture is held in reduction while the plate is positioned on the clavicle and temporarily fixated with the use of a bbtak pin. The synthes lcp proximal tibia plate is intended for treatment of nonunions, malunions. These anatomically contoured plates increase screw purchase in the clavicle and act as a template to aid with anatomic restoration. The acumed anterior clavicle plate is designed for surgeons who prefer an anterior approach to treat malunions, nonunions, and fractures of the medial, midshaft, and lateral third clavicle. The anatomically precontoured fixation system with angular stability for clavicle shaft and lateral clavicle. Userfriendly, innovative instrumentation aids to further simplify the technique for the surgeon. Nine patients were operated using the t plate technique and six using coracoclavicular fixation with anchors. Millett, md, msc steadman philippon research institute, vail, co, usa clavicle fractures are common in adults and children. Lcp superior clavicle plate surgical technique depuysynthes 1 table of contents introduction. Clavicle plate and screw system surgical technique. Clavicle hook plates features dynamic compression screw holes accept 3.
Plates utilize smartlock technology which permits polyaxial screw placement. Open reduction and internal fixation of a distal clavicle. Arthroscopicassisted locking compression plate clavicular. Surgical treatment of distal clavicle fractures using the clavicular hook plate article in clinical orthopaedics and related research 447447. This site is published by the depuy synthes companies, which are solely responsible for its content. Surgical managements are recommended for unstable distal clavicle fractures because of a high incidence of nonunion. Clavicular hook plate may induce subacromial shoulder impingement and rotator cuff lesion. One surgical method commonly used for distal clavicle fractures is hook plate fixation. Clavicle fracture open reduction internal fixation. The lcp clavicle hook plate, combined with ao technique, provides stable fracture fixation with minimal trauma to vascular supplies. The locking compression plate system has many similarities to conventional plate fixation methods, but with a few important improvements.
Distal medial tibia plate distal lateral femoral plate proximal lateral tibial plate the axsos locking plate system is designed to treat periarticular or intraarticular fractures of the proximal humerus, distal femur. Ao surgery reference is a resource for the management of fractures, based on current clinical principles, practices and available evidence. Fragment locking compression plate technique guide does not deal with any specific fracture. The variax clavicle locking plate system is an anatomically shaped, variable angled locking plate system. Large fragment locking compression plate lcp technique guide. Orif distal clavicle with synthes distal clavicle locking plate. We used a new internal fixative implant, the ao clavicle hook plate, for treatment of unstable fractures of the distal clavicle. However, due to the nature of the injury and the patients desire to return to activity, open reduction and internal fixation were planned. The ideal fixation method for unstable distal clavicle fractures is still controversial. Dec 09, 2009 the need for a second surgical procedure to remove the implant in order to avoid progressive acromial osteolysis is a significant disadvantage of this technique. Once the plate shaft is placed on the clavicle, the end of the hook should be in. Clavicular hook plates hps are an effective option but the clinical efficacy and advantagesdisadvantages of this implant compared with the tension band wire technique in treating this fracture have not been determined. By sonographic evaluation, we thus intended to determine whether the presence of hook. Orif distal clavicle with synthes distal clavicle locking.
We used a new internal fixative implant, the ao clavicle hookplate, for treatment of unstable fractures of the distal clavicle. This study describes the operative procedure and the clinical results obtained, as well as discussion of the advantages and problems encountered. Surgical treatment of distal clavicle fractures using the. A novel fluoroscopic view for positioning the ao clavicle hook plate. Surgical technique after administration of general anesthesia, the patient was placed. Our surgical technique consisted of application of basic reduction and plating methods, following the operative procedure as advised by the synthes clavicle hook plate technique guide 2003 synthes. The technique description herein is made available to the healthcare professional to illustrate the treatment for the uncomplicated procedure. Variax clavicle locking plate system stryker meded. A variety of methods have been previously reported, but there is no current consensus regarding which method is the most suitable. We describe a technique of using a modified hook plate to fix a displaced medial clavicle fracture as one of the treatment options. A hook plate assembly includes a bone plate extending along a longitudinal axis from a first end to a second end and including an upper surface facing away from a bone, a bone contacting surface, a plate hole extending therethrough from the upper surface to the bone contacting surface and a connection section arranged at the second end.
Fixation of unstable type ii clavicle fractures with distal clavicle plate and suture button peters. The need for a second surgical procedure to remove the implant in order to avoid progressive acromial osteolysis is a significant disadvantage of this technique. There are several surgical procedures for distal clavicle fracture, but its indication is unclear. By sonographic evaluation, we thus intended to determine whether the presence. Place the shaft of the plate onto the superior aspect of the clavicle. Clavicle system offers three families of plating solutions based on varied fracture patterns and surgeon preference. It was also not necessary to remove any plate because the one used here had a thickness of only 2 mm, whereas the thickness of dcp and hook plates is 3. Most clavicle fractures can be successfully treated by conser. The variax 2 clavicle plating systems provides surgeons with a comprehensive range of anatomic plating options that work with a common instrument and screw platform. Plate families are colorcoded for quick distinguishing in the or. In the final analysis, the preferred treatment is that which addresses the needs of the specific patient. Between december 2004 and august 2010, we treated 68 patients with neer type iib distal clavicle fractures using single coracoclavicular suture.
Surgical technique continued sutures the plate should be centered against the lateral aspect of the greater tuberosity sutures have been omitted for clarity. The surgery for patients with neer ii lateral clavicle fracture and degreeiii ac. Complete disaster full interior car detailing transformation. Clavicular hook plate may induce subacromial shoulder. Part of the synthes locking compression plate lcp system 3. Fifteen consecutive patients with unstable fractures of the distal clavicle neer type ii were treated using ao clavicle. With this in mind, stryker has developed the variax clavicle locking plate system.
The clavicle hook plate is a good primary treatment option for the acute. May 29, 2014 surgical managements are recommended for unstable distal clavicle fractures because of a high incidence of nonunion. Fractures of the lateral clavicle lcp clavicle hook plate acromioclavicular joint. We report 3 cases of fixation failure following treatment with a clavicular hook plate.
Apply posterolateral plateinsert first screw in elongated shaft hole, then insert distal screws apply medial plateinsert first screw in elongated shaft hole, then insert distal screws use 3. Surgical technique reduce fracture and fix temporarily for ctype fractures, reduce the articular fragments of the distal block under image intensification and use kirschner wires andor pointed reduction. Surgical treatment for unstable distal clavicle fracture. This shows an open reduction and internal fixationorif of the distal clavicle using a synthes locking plate. A choice of a midshaft or lateral plate is determined by the site of the fracture. May 05, 20 this shows an open reduction and internal fixationorif of the distal clavicle using a synthes locking plate. Anatomy the collarbone clavicle is located between the. Complications of clavicle fractures treated with intramedullary. Our trauma and extremities portfolio offers you marketleading implants for the treatment of long and small bone fractures, as well as extremity joint replacements. However, increasing number of studies has revealed that subacromial portion of the hook may induce acromial bony erosion, shoulder impingement, or even rotator cuff damage. Clavicle plate and screw system the clavicle plate and screw system is a comprehensive set of plates, screws and instrumentation designed to treat central third and distal clavicle fractures. In the final analysis, the preferred treatment is that which. The stainless steel plates are low profile and precontoured with locking and nonlocking screw options in. A synthes hook plate was used, with planned removal in four to six months following surgery.
1145 317 644 1403 222 1142 1265 1301 1215 548 258 1388 828 465 135 1014 1234 1527 401 566 1349 192 438 1262 1308 1309 1336 556 1378 631 1206 606