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Beitragstitel Surgical treatment of Neer type V lateral clavicle fractures – a comparative study in human cadavers
Beitragscode P07
  1. Paul Borbas Balgrist Vortragender
  2. Alexander Paszicsnyek Universitätsklinik Balgrist
  3. Simon Hofstede Universitätsklinik Balgrist
  4. Lukas Ernstbrunner Universitätsklinik Balgrist
  5. Karl Wieser Universitätsklinik Balgrist
Präsentationsform Poster
  • A01 - Schulter/Ellbogen
Abstract Background:
Treatment of distal clavicle fractures with bony avulsion of the coracoclavicular (CC) ligaments is challenging and a single gold-standard surgical technique has not yet been defined. The purpose of this study was to investigate the biomechanical fixation strength of the CC stand-alone Cow-Hitch suture repair technique in comparison with the clavicle hook plate and the lateral locking plate with CC suture repair fixation techniques.
3D guided Neer Type V fractures of the clavicle were created in 18 cadaveric shoulders, which were matched by age and gender in 3 groups: (1) clavicle hook plate (Group HP), (2) lateral locking plate fixation with CC suture repair (Group LPCC) and (3) stand-alone suture repair using the Cow-Hitch technique (Group CH). After preconditioning with 25 N for 10 cycles the specimens were cycled for 500 cycles from 10N to 70N. Displacement and ultimate load to failure were documented and analyzed with the data acquisition system.
There was a significant difference in the fracture displacement during cyclic loading between the LPCC group and the HP group (0.6 vs. 1.7 mm; p = 0.02), as well as between CH and HP group (0.5 vs. 1.7 mm; p = 0.004). There was no significant difference between the LPCC group and the CH group (p = 0.544). The CH group and the LPCC group showed a significant higher stiffness compared to the HP group (p < 0.001 and p = 0.003 respectively). The CH group showed a significant higher ultimate load to failure compared with the HP group (429 vs. 172 N; p = 0.005), but not compared with the LPCC group (428.7 vs. 258.2 N; p = 0.071).
The CC-Stand-Alone Cow-Hitch technique and the locking plate fixation technique with suture repair showed superior biomechanical results than the hook plate in fixation of Neer type V fractures of the distal clavicle. Both techniques showed comparable biomechanical fixation strength, however, the CH technique has potential advantages such as less soft tissue stripping, low costs, and simple technique.