Operative Treatment of Distal Clavicle Fracture with Acromioclavicular Joint Injury
Journal of the Korean shoulder and elbow society (대한견・주관절학회지)
Journal of the Korean shoulder and elbow society (대한견・주관절학회지), Vol.14(1) : 59~66, 2011
Purpose: We wanted to evaluate the clinical and radiological outcomes and the prognosis of various surgical
treatments for the distal clavicle fracture with an acromioclavicular joint injury.
Materials and Methods: A retrospective study of 21 patients with a minimum of 12 months follow up
was done. We classified acromioclavicular (AC) injury into type I (only intra-articular fracture (IAF), 5
cases), type II (IAF with widening of the AC joint > 7 mm, 9 cases) and type III (IAF with AC joint superior
subluxation > 50%, 7 cases). The distal clavicle fractures were fixed using plate (9 cases), mini
screws (1 case), K wire and tension band wiring (10 cases) and transarticular pinning (1 case). Acromioclavicular
or coracoacromial ligament reconstruction was not done in all the cases.
Results: In 20 of 21 cases, bone union was achieved at an average of 8.4 weeks. Traumatic arthritis (5
cases), AC joint widening (4 cases) and AC joint subluxation (2 cases) were noted at the last follow up.
The average UCLA score was 32.6 in the type I AC joint injuries, 34 in type II and 34.1 in type III. There
was no relationship between the clinical outcomes and the preoperative AC joint injury pattern, postoperative
traumatic arthritis, AC joint widening or AC joint subluxation (p>0.05).
Conclusion: Satisfactory results were achieved by acute reduction and firm fixation of the distal clavicle
fracture with AC joint injury. There was no relationship between the pattern of AC joint injury, the residual
radiologic findings and the functional outcome.