Abstract
Many authors have recommended surgical treatment for an unstable type of distal clavicle fracture. However it is usually difficult to achieve stable fixation in some cases especially with small distal fragments and comminuted fragment.
Nineteen patients with distal clavicle fracture who had operative treatment between January 1996 and June 2000 in the author's hospital were used in study. There were 16 males and 3 females, aged 10-66 years; average 34.5 years. All cases were classified as distal clavicle fractures Neer II type. We treated 12 fractures with Kirschner wires+figure 8 wiring (KW), 5 fractures by AO small T plate (T-plate), 3 patients by Wolter clavicle plate (Wolter plate).
Ultimately all patients had mature union of fracture, did not have any residual pain or functional disorders. There were some complications in the KW cases, 1 delayed union case, 2 deformed union cases, and 1 reoperated case used a Wolter plate because of wire cut out. T-plate cases and Wolter plate cases did not have any complications caused by instability.
KW fixation had usually good results in unstable types of distal clavicle fractures. But in some cases with small distal fragments and comminuted fragments, the KW method alone did not yield successful stable fixation. The authors found that the Wolter clavicle plate was a useful augmentation in these cases.
