Abstract
Introduction Unstable distal clavicle fractures have a high rate of non and delayed union, with many authors recommending surgical fixation. There are several techniques described in the literature reporting good results. We report the outcome of eighteen patients undergoing temporary fixation with a coracoclavicular screw, reinforced with Mersilene tape and Ethibond sutures.
Methods Eighteen patients were treated by a single surgeon between October 1999 and March 2003. All patients were male with an average age of 35 years. The indication for surgery was an unstable Type II fracture of the distal third clavicle. Fixation was achieved with a 6.5 mm cancellous screw through the clavicle into the coracoid process, reinforced by Mersilene tape and number 5 Ethibond sutures around the coracoid process. The arm was immobilized for two to four weeks after surgery. Each patient had the screw removed at about 11 weeks from surgery.
Results Eighteen patients achieved osseous union with painless range of motion. Union time ranged between six to 11 weeks. One patient developed a superficial skin infection, which settled with oral antibiotics, the scar required revision at time of screw removal. Two patients had screw breakage after union, which did not affect their outcome. There was no cases of screw penetration.
Conclusions This method of screw fixation is a relatively safe and easy technique of open reduction and internal fixation of the unstable distal third of clavicle. The outcome of this procedure is predictable with minimal complications.
The abstracts were prepared by Mr Jerzy Sikorski. Correspondence should be addressed to him at the Australian Orthopaedic Association, Ground Floor, William Bland Centre, 229 Macquarie Street, Sydney NSW 2000, Australia.
None of the authors have received any payment or consideration from any source for the conduct of this study.
