1/2. The treatment of distal clavicle fractures with coracoclavicular ligament disruption: a report of 10 cases.OBJECTIVE: Fractures of the distal third of the clavicle with coracoclavicular ligament disruption have been associated with delayed union or nonunion. A combined surgical technique for the fracture fixation and ligament repair for acute fractures was developed. The technique includes K-wire fixation and suture anchor placement with Ethibond suture to the coracoid process. The results of this combined technique were evaluated. DESIGN: Prospective, consecutive case series. SETTING: Surgical treatment was performed at the Department of orthopedics and traumatology. patients: Ten patients with acute fractures of the distal third of the clavicle were enrolled with a mean follow-up period of 24.1 (range, 12-36) months. INTERVENTION: A single suture anchor was placed on the coracoid process in a vertical position. The Ethibond suture attached to the anchor was used to depress the elevated proximal part of the clavicle by pulling it down to the coracoid process where the anchor was placed. The suture was pulled over the proximal clavicle and tied. The distal fragment was fixed to the proximal clavicle by an intramedullary K-wire. The torn coracoclavicular ligaments were approximated using absorbable suture. MAIN OUTCOME MEASUREMENTS: The patients were evaluated by the Constant scores and Modified shoulder Rating Scale. RESULTS: The mean Constant score was 96.6 points in the last follow-up. Nine patients had excellent results, and 1 patient had a good result, using the Modified shoulder Rating Scale. CONCLUSIONS: This is a reliable technique with encouraging results for treating displaced distal third clavicle fractures with coracoclavicular ligament disruption.- - - - - - - - - - ranking = 1keywords = ligament (Clic here for more details about this article) |
2/2. Fracture separation of the coracoid process associated with acromioclavicular dislocation: conservative treatment--a case report and review of the literature.Complete acromioclavicular dislocation associated with fracture separation of the base of the coracoid process is uncommon. This is a report of a 51-year-old man with severe emphysema and limited physical demands in whom the acromioclavicular dislocation and coracoid process fracture were treated conservatively with sling immobilization and early motion and exercises. Good power and full, painless range of motion with minimal symptoms was observed at 6 months follow-up. The strong coracoclavicular ligaments, rather than rupture, may avulse the coracoid process near its base and with disruption of the acromioclavicular joint may allow complete dislocation of the clavicle. A satisfactory result may be obtained without operative reduction of either the acromioclavicular joint or the coracoid process.- - - - - - - - - - ranking = 0.125keywords = ligament (Clic here for more details about this article) |