Orthopedics · 2026
A Novel Technique for Midshaft Clavicle Fracture With Ipsilateral Acromioclavicular Dislocation: Titanium Elastic Nail Combined With Coracoclavicular Ligament Reconstruction and Joint Capsule Suture.
СтатьяНазвание и аннотация: Перевод в очереди
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Zeng Lu-Lu, Wu Hai-Lin, Li Yuan-Hui, Fu Heng, Jiang Yu-Wen, Zeng Lang-Qing
Аннотация
BACKGROUND: Midshaft clavicle fracture (MSCF) combined with ipsilateral acromioclavicular joint dislocations (ACJD) are rare injuries with no consensus on optimal management. This study evaluated a novel technique using a titanium elastic nail (TEN) for MSCF fixation combined with coracoclavicular (CC) ligament reconstruction and acromioclavicular (AC) joint capsule repair for ACJD stabilization.
MATERIALS AND METHODS: This retrospective study included 7 patients with MSCF and ipsilateral ACJD who were treated between November 2017 and February 2024. Surgical procedures involved TEN fixation for the MSCF and CC ligament reconstruction with No. 5 Ethibond sutures, augmented with AC joint capsule suturing using No. 2 Ethibond sutures. Clinical assessments included the Constant-Murley score (CMS), Disabilities of the Arm, Shoulder, and Hand (DASH) score, visual analog scale (VAS), range of motion, radiographs, and complications.
RESULTS: Mean follow-up was 24.9 months. All fractures healed at a mean of 10.9 weeks. The mean CMS was 95.9 points (range, 92-100 points), the mean DASH was 5.0 points (range, 2-9 points), and the mean VAS was 0.4 points (range, 0-2 points). The mean active forward flexion, abduction, external rotation, and internal rotation (level) were 175°, 169°, 56°, and T9, respectively. One patient required nail removal for persistent skin irritation. No major complications occurred, including nonunion, implant failure, AC joint arthritis, or recurrent dislocation.
CONCLUSIONS: The simple, combined technique of TEN fixation with CC ligament and AC joint capsule reconstruction provided reliable stability and satisfactory short-term radiographic and functional outcomes for MSCF with ipsilateral ACJD, representing a viable, minimally invasive alternative.
MATERIALS AND METHODS: This retrospective study included 7 patients with MSCF and ipsilateral ACJD who were treated between November 2017 and February 2024. Surgical procedures involved TEN fixation for the MSCF and CC ligament reconstruction with No. 5 Ethibond sutures, augmented with AC joint capsule suturing using No. 2 Ethibond sutures. Clinical assessments included the Constant-Murley score (CMS), Disabilities of the Arm, Shoulder, and Hand (DASH) score, visual analog scale (VAS), range of motion, radiographs, and complications.
RESULTS: Mean follow-up was 24.9 months. All fractures healed at a mean of 10.9 weeks. The mean CMS was 95.9 points (range, 92-100 points), the mean DASH was 5.0 points (range, 2-9 points), and the mean VAS was 0.4 points (range, 0-2 points). The mean active forward flexion, abduction, external rotation, and internal rotation (level) were 175°, 169°, 56°, and T9, respectively. One patient required nail removal for persistent skin irritation. No major complications occurred, including nonunion, implant failure, AC joint arthritis, or recurrent dislocation.
CONCLUSIONS: The simple, combined technique of TEN fixation with CC ligament and AC joint capsule reconstruction provided reliable stability and satisfactory short-term radiographic and functional outcomes for MSCF with ipsilateral ACJD, representing a viable, minimally invasive alternative.