gms | German Medical Science

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2018)

23.10. - 26.10.2018, Berlin

Which lateral clavicle fractures can be treated by an arthroscopic assisted Endobutton procedure? – An analysis of risk factors

Meeting Abstract

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  • presenting/speaker Emanuel Kuner - Luzerner Kantonsspital, Wolhusen, Switzerland
  • Frank J. P. Beeres - Luzerner Kantonsspital, Luzern, Switzerland
  • Reto Babst - Luzerner Kantonsspital, Luzern, Switzerland
  • Ralf Schöniger - Luzerner Kantonsspital, Luzern, Switzerland

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2018). Berlin, 23.-26.10.2018. Düsseldorf: German Medical Science GMS Publishing House; 2018. DocPT26-772

doi: 10.3205/18dkou798, urn:nbn:de:0183-18dkou7987

Veröffentlicht: 6. November 2018

© 2018 Kuner et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objectives: Arthroscopic assisted treatment of lateral clavicle fractures with CC stabilization gain popularity over the last years. Several studies show favorable results with this technique. But still there is no consensus about the optimal treatment of these fractures. Also, there is little evidence which types of lateral clavicular fractures are suitable for arthroscopic assisted treatment with an endobutton device.

The primary aim of this study was to evaluate the clinical und radiological outcome of an arthroscopic assisted treatment of acute lateral clavicle fractures with a endobutton device (DogBone/ TightRope-Button, Arthrex; Napels, USA) and to specify which fracture type is best addressed with this method. The secondary outcome was to evaluate potential risk factors for complications.

Methods: Retrospective single center review of 20 unstable lateral clavicle fractures treated with an arthroscopic assisted CC-stabilization technique between September 2012 and August 2016. The endobutton device used were either a DogBone- or TightRope-Button (Arthrex, Napels, USA). Data pertaining to demographics and postoperative complications were collected. Fractures were classified according to the Neer-Classification and time to radiological union and secondary loss of reposition were analyzed. The functional outcome was evaluated with Constant- and DASH-Scores, VAS and SSV.

Results: Between September 2012 and August 2016, 217 patients with clavicle fractures were operated at our clinic. 28 of those were lateral clavicle fractures. 20 were treated with the above mentioned method with an average age of 45 year (male: female ratio 14:6). In those cases with a follow up at least twelve months (12-50) were bony healing was observed the DASH-Score was on average 2.0 (0-9.82). The Constant-Score had an average of 81.8 (range, 68-93) points and the average difference between the affected and the unaffected side was 4.1 points (range, 0-15) in the same group. No infections or coracoid fractures have been reported. Six patients developed a nonunion of which two needed revision. Two patients developed a frozen shoulder.

Conclusion: Our results show that arthroscopic assisted CC stabilization with an endobutton technique allows good functional results by adult patients of all ages. Very lateral unstable clavicle fractures seem to be especially suitable for this surgical technique. The high number of delayed unions however warrants further analysis and future research should focus on this topic. Analysis of risk factors showed that early mechanical stress, a lateral clavicular fragment bigger than 3 cm and a time delay to surgery could be risk factors for these nonunions.