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Beitragstitel Lateral clavicular fractures associated with acromioclavicular luxation: A surgical technique
Beitragscode P10
Autoren
  1. Nermine Habib Swiss Diabetic Foot Centers Vortragender
  2. Helmstetter Timothée Clinique La Colline Genève
  3. Paolo Fornaciari HFR Fribourg Cantonal Hospital, University of Fribourg
  4. Grégoire Thürig KS Schaffhausen
  5. Moritz Tannast HFR Fribourg - University of Fribourg
  6. Philippe Vial HFR Fribourg Cantonal Hospital, University of Fribourg
Präsentationsform Poster
Themengebiete
  • A01 - Schulter/Ellbogen
Abstract BACKGROUND
Unstable distal clavicle fractures associated with lesions of the coracoclavicular (CC) ligaments demonstrate a high symptomatic nonunion rate if treated conservatively. A wide variety of surgical techniques have been described. Many of these techniques were associated with high failure rates and hardware-related complications. Therefore, we have adopted a surgical technique that aims at stabilization of the CC ligaments in combination with osteosynthesis of the clavicle.

We questioned: (i) Loss of reduction or loosening of the CC ligaments, (ii) The clinical function in terms of the Oxford Shoulder Score (OSS); American Shoulder and Elbow Surgeons Shoulder Score (ASES); Visual Analogue Scale (VAS), (iii) Return to work, (iv) Return to sports.

METHODS
A retrospective single-center case series. Between 2015 and 2019, patients who had a lateral clavicular fracture associated with a CC ligament lesion and underwent stabilization of the CC ligaments by FiberWire® and osteosynthesis by low-profile plating (thickness 1.3mm). Only acute lesions were included.
Thirteen patients, with an average age of 48 years, had a clinical and/or radiological average follow-up of 3 years.

RESULTS
Only one of the patients showed loosening of more than 5 mm of the CC ligaments, without horizontal instability and was completely asymptomatic. No loss of reduction was determined.
The clinical function at an average of 38 months showed a complete recovery in 10 of the patients. The average OSS was 47 out of 48, the average ASES 99, and the VAS 0.
All the patients, except two pensioners, went back to work within two months and back to sports within five months of the operation.
Four of the patients were reoperated with the removal of the implants due to discomfort. No other complications were encountered.

CONCLUSION
Stabilization of the CC ligaments in combination with osteosynthesis of the lateral clavicle using low profile plating provides a surgical treatment option with complication rates consistent with the current literature, a very satisfactory clinical outcome, as well as early return to work and sports.

KEYWORDS
Coracoclavicular ligaments; Fracture; Stabilization; Osteosynthesis