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Title: [Effectiveness of Kirschner wire fixation and coracoclavicular ligament reconstruction with suture anchor in treatment of Cho type ⅡC distal clavicle fractures].
Author: Zhao S, Li X, Zhang W, Zhao J, Zeng Z, Wang A.
Journal: Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi; 2023 Nov 15; 37(11):1370-1374. PubMed ID: 37987046.
Abstract:
OBJECTIVE: To evaluate the effectiveness of Kirschner wire fixation and coracoclavicular ligament reconstruction with suture anchor in the treatment of Cho type ⅡC distal clavicle fractures. METHODS: The data of 17 patients with Cho type ⅡC distal clavicular fractures, who were treated with Kirschner wire fixation and coracoclavicular ligament reconstruction with suture anchor between June 2019 and June 2021, was retrospectively analyzed. There were 11 males and 6 females with an average age of 38.7 years (range, 19-72 years). The fractures were caused by falling in 12 cases and traffic accident in 5 cases. All patients had fresh closed fractures. The interval from injury to operation was 1-5 days (mean, 2.6 days). The preoperative injury severity score (ISS) was 6-27 (mean, 10.2). The operation time, intraoperative blood loss, hospital stay, fracture healing, and postoperative complications were analyzed. The shoulder joint function was evaluated by disabilities of the arm, shoulder, and hand (DASH) score and Constant score at last follow-up. RESULTS: All operations were completed successfully. The operation time was 20-50 minutes (mean, 31.6 minutes). The intraoperative blood loss was 30-100 mL (mean, 50.6 mL). The hospital stay was 4-9 days (mean, 5.3 days). All incisions healed by first intention. All patients were followed up 12-16 months (mean, 13 months). All clavicle fractures healed, and the healing time was 8-15 weeks (mean, 11 weeks). No complications such as fracture displacement or nonunion caused by internal fixation failure occurred. During the follow-up, skin irritation caused by the Kirschner wire withdrawal occurred in 3 cases. The Kirschner wires were removed after fracture healing in 17 patients. At last follow-up, the Constant score of shoulder joint was 90-100 (mean, 98.2). The DASH score was 0-10 (mean, 1.5). CONCLUSION: Kirschner wire fixation combined with coracoclavicular ligament reconstruction with suture anchor in the treatment of Cho type ⅡC distal clavicle fractures has less postoperative complications and slight complications. It is convenient to remove the internal fixator. The Kirschner wire does not fix the distal clavicle fracture through the acromion, which has little effect on shoulder joint function and can obtain good effectiveness. 目的: 探讨克氏针联合缝合锚钉重建喙锁韧带治疗Cho ⅡC型锁骨远端骨折的疗效。. 方法: 回顾性分析2019年6月—2021年6月使用克氏针联合缝合锚钉重建喙锁韧带治疗的17例Cho ⅡC型锁骨远端骨折患者临床资料。男11例，女6例；年龄19～72岁，平均38.7岁。致伤原因：摔伤12例，交通事故伤5例。均为新鲜闭合骨折；受伤至手术时间1～5 d，平均2.6 d。创伤严重程度评分（ISS）为6～27分，平均10.2分。记录手术时间、术中出血量、住院时间、骨折愈合情况和术后并发症发生情况。末次随访时，采用上肢功能障碍评定表（DASH）评分以及肩关节Constant评分评价肩关节功能。. 结果: 手术均顺利完成，手术时间20～50 min，平均31.6 min；术中出血量30～100 mL，平均50.6 mL；住院时间4～9 d，平均5.3 d。术后切口均Ⅰ期愈合。患者均获随访，随访时间12～16个月，平均13个月。锁骨骨折均愈合，愈合时间8～15周，平均11周；无内固定物失效导致的骨折移位、骨折不愈合等并发症发生。随访期间3例患者发生克氏针尾端刺激皮肤情况。17例患者均在骨折愈合后取出克氏针。末次随访时，肩关节Constant评分为90～100分，平均98.2分；DASH评分为0～10分，平均1.5分。. 结论: 克氏针联合缝合锚钉重建喙锁韧带治疗ChoⅡC型锁骨远端骨折术后并发症少且轻微，去除内固定物方便；克氏针不经肩峰固定锁骨远端骨折端，对肩关节功能影响小，可获得较好临床疗效。.

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