Clavicle fractures are among the most prevalent types of fractures with numerous treatment strategies that have evolved over time.In the realm of lateral-third clavicle fracture management,several surgical methods are...Clavicle fractures are among the most prevalent types of fractures with numerous treatment strategies that have evolved over time.In the realm of lateral-third clavicle fracture management,several surgical methods are available,with plate and screw constructs being one of the most frequently employed options.Within this construct,numerous choices exist for fixing the fracture.This editorial provides an overview of the common plate options utilized in the management of distal third clavicle fractures underscoring the critical considerations and approaches that guide clinicians in selecting the most appropriate fixation techniques,considering the complex landscape of clavicle fractures and their challenging management.展开更多
Purpose: Acromioclavicular (AC) joint dislocation is commonly treated using a clavicle hook plate (HP). However, previous reports have indicated that acromial fractures may occur after HP fixation. The purpose of this...Purpose: Acromioclavicular (AC) joint dislocation is commonly treated using a clavicle hook plate (HP). However, previous reports have indicated that acromial fractures may occur after HP fixation. The purpose of this study was to identify risk factors for acromial fractures. Methods: A retrospective study was conducted on 39 patients with AC joint dislocation who were treated using clavicle HP fixation in our hospital between 2006 and 2017. Related parameters, including Rockwood classification, hook angle, the degree of reduction, the coverage of the hook under the acromion, and the anteroposterior position of the hook under the acromion, were evaluated to identify risk factors for acromial fractures. Results: The mean age of the participants was 51.7 (range 19 - 81) years;34 were men and 5 were women. Injury occurred on the right side in 18 patients and on the left side in 21. Injuries were categorized as follows: 24 were Rockwood type III, one was type IV, and 14 were type V. Four of the 39 patients (10%) experienced acromial fractures. Statistical analyses indicated that the degree of reduction at the final follow-up was moderately correlated with the Constant score. Posterior positioning of the hook was the only identified risk factor for acromial fractures. Hook angle and the degree of reduction at the time of surgery were not significantly associated with acromial fractures. Conclusions: Postoperative shoulder function was associated with the degree of reduction at the final follow-up, suggesting that anatomical reduction is recommended for AC joint dislocation. Posterior positioning of the hook is a risk factor for acromial fractures;however, clavicle HP fixation provides a positive outcome for AC joint dislocation. Therefore, careful positioning of the hook is required for preventing acromial fractures.展开更多
BACKGROUND For the treatment of distal clavicle fractures,each treatment method has its own advantages and disadvantages,and there is no optimal surgical solution.CASE SUMMARY Based on this,we report 2 cases of distal...BACKGROUND For the treatment of distal clavicle fractures,each treatment method has its own advantages and disadvantages,and there is no optimal surgical solution.CASE SUMMARY Based on this,we report 2 cases of distal clavicle fractures treated utilizing an anterior inferior plate with a single screw placed in the distal,in anticipation of providing a better surgical approach to distal clavicle fracture treatment.Two patients were admitted to the hospital after trauma with a diagnosis of distal clavicle fracture,and were admitted to the hospital for internal fixation of clavicle fracture by incision and reduction,with good postoperative functional recovery.CONCLUSION With solid postoperative fixation and satisfactory prognostic functional recovery,this technique has been shown to be simple,easy to perform and effective.展开更多
Background: Clavicular hook plates are effective fixation devices for lateral end clavicle fractures and acromioclavicular joint dislocations and have been extensively used in the last decade. Although this plate achi...Background: Clavicular hook plates are effective fixation devices for lateral end clavicle fractures and acromioclavicular joint dislocations and have been extensively used in the last decade. Although this plate achieves a high percentage of union, there are concerns about sub-acromial osteolysis and impingement of supraspinatus tendon. Objective: To show that impingement of supraspinatus tendon can be prevented by measuring the depth between acromion and supraspinatus tendon posteriorly and using hook plates of appropriate depth. Materials and Methods: We performed a prospective study on 25 patients with lateral end clavicle fractures and acromio clavicular joint disruptions by measuring the depth between posterior border of acromion and the superior border of supraspinatus at the point of application of hook plate. Fixation is then done by appropriate sized hook plate. Results: None of the patients had impingement of supraspinatus tendon. Five patients developed subacromial osteolysis which did not have any impact on shoulder function. Conclusion: There is a variation in anatomy of the acromion in different ethnic groups. Hence uniform sized hook plate will be inappropriate. A smaller hook depth is needed in south Asian population to prevent impingement.展开更多
Objective:To investigate the mechanical properties of a new type of biplane locking plate with wings in the treatment of middle clavicle fractures.Methods:Based on the CT data of a healthy adult male volunteer’s clav...Objective:To investigate the mechanical properties of a new type of biplane locking plate with wings in the treatment of middle clavicle fractures.Methods:Based on the CT data of a healthy adult male volunteer’s clavicle,a three-dimensional finite element model of the middle clavicle fracture was constructed by digital three-dimensional reconstruction technology,and the two kinds of fixation methods of single-plane locking plate(SP)and wing plate(WP)were simulated.Four load cases of axial compression,axial torsion,cantilever bending and pull-out were used to analyze the models.Results:①Under axial compression,axial torsion,cantilever bending and pull-out conditions,compared with SP,the stiffness phase of WP increased by 1.47%,5.82%,1.51%and 3.96%respectively,and the strain energy decreased by 1.50%,5.39%,1.48%and 3.49%respectively.②The stress distribution characteristics of WP under various load conditions were similar to SP,and the high stress area was located around the screw hole of the steel plate above the fracture gap;③Under the pull-out condition of WP,the peak value of screw hole surface stress was greatly reduced compared with SP,especially in the screw hole on both sides of the wing screws,which had higher resistance to pull out.Conclusion:The load-bearing mode of WP under various load conditions is similar to that of SP,and the stability is slightly higher than that of SP and in terms of pull-out resistance,WP has more obvious advantages.The biplane locking plate with wings is expected to be a more ideal choice for patients with comminuted fracture of the middle clavicle or with osteoporosis.展开更多
BACKGROUND Shoulder injuries caused by trauma are common,including clavicle fractures.Even so,bipolar segmental fracture of the clavicle is extremely rare and seldom reported.Therefore,there is still a controversial i...BACKGROUND Shoulder injuries caused by trauma are common,including clavicle fractures.Even so,bipolar segmental fracture of the clavicle is extremely rare and seldom reported.Therefore,there is still a controversial issue about how to treat these bipolar segmental clavicle fractures.CASE SUMMARY A 56-year-old security guard arrived at our emergency room after falling on his electric bicycle.There was no loss of consciousness or other pain.He had no numbness in his fingers.X-rays and 3D computed tomography revealed that the patient’s right shoulder had a bipolar segmental clavicle fracture.The surgical procedure included both open reduction and internal fixation.At the 1-year follow-up,he had a full range of motion and minimal discomfort in the injured shoulder.CONCLUSION We provide a rare case of bipolar clavicle facture in the right clavicle.We hold the opinion that such patients would get better clinical and radiological outcomes by early and correct operation.展开更多
Objective:To explore the treatment of TOSSY type III acromioclavicular joint dislocation with clavicular hook plate combined with coracoclavicular ligament repair and its clinical effect.Methods:80 patients with TOSSY...Objective:To explore the treatment of TOSSY type III acromioclavicular joint dislocation with clavicular hook plate combined with coracoclavicular ligament repair and its clinical effect.Methods:80 patients with TOSSY type III acromioclavicular joint dislocation who were admitted to our hospital from January 2014 to January 2019 were selected.They were randomly divided into the control group(n=39,treated with clavicular hook plate)and the observation group(n=41,treated with clavicular hook plate combined with coracoclavicular ligament repair)by the random number table method.The clinical efficacy in 12 months after operation,related clinical indicators,12-month postoperative recovery and postoperative complications were compared between the two groups.Results:The excellent and good rate was 92.68%(38/41)in 12 months after operation in the observation group,which was higher than that(76.92%,30/39)in the control group(p<.05).There were no significant differences in the duration of surgery,intraoperative blood loss and HLOS between the observation group and the control group(p>.05).In 12 months after operation,abduction activity and forward flexion activity of the observation group were higher than those of the control group,and visual analogue score(VAS)was lower than that of the control group(p<.05).The incidence of complications in the observation group was slightly lower than that in the control group,but there was no statistically significant difference between the two groups(p>.05).Conclusions:For TOSSY type III acromioclavicular joint dislocation,clavicular hook plate combined with coracoclavicular ligament repair has a good clinical efficacy.It can improve shoulder joint function,alleviate shoulder pain and have fewer complications.It can provide a reference for clinical treatment of this type of acromioclavicular joint dislocation.展开更多
目的探讨与分析解剖钢板内固定系统和重建钢板固定治疗锁骨中段骨折的效果。方法选择2019年1月—2022年10月在苏州市吴江区第五人民医院入院并接受手术治疗的88例锁骨中段骨折患者作为研究对象,根据1:1随机掷骰子原则把88例患者分为解剖...目的探讨与分析解剖钢板内固定系统和重建钢板固定治疗锁骨中段骨折的效果。方法选择2019年1月—2022年10月在苏州市吴江区第五人民医院入院并接受手术治疗的88例锁骨中段骨折患者作为研究对象,根据1:1随机掷骰子原则把88例患者分为解剖组44例与重建组44例。重建组给予重建钢板固定治疗,解剖组给予解剖钢板内固定系统治疗,记录与观察两组的治疗效果。结果两组术中出血量、手术时间、切口长度对比,差异无统计学意义(P>0.05),解剖组术后住院时间、术后切口愈合时间、术后骨折创面愈合时间与重建组对比有显著减少(P<0.05)。解剖组术后3个月的肩峰下撞击征、植入物松动、肩关节炎、切口感染、静脉血栓等并发症发生率为4.55%,重建组为20.45%,解剖组与重建组对比有明显降低(P<0.05)。解剖组术后3个月的骨折复位质量优良率为97.73%,显著高于重建组的84.09%(P<0.05)。解剖组术后3个月的总体疗效优良率为95.45%,与重建组的相比有显著提高81.82%(P<0.05)。两组术后3个月的Constant and Murley评分明显高于术前1 d(P<0.05),且解剖组术后3个月的Constant and Murley评分明显高于重建组(P<0.05)。结论相对于重建钢板内固定系统,解剖钢板内固定系统治疗锁骨中段骨折能促进患者的康复与骨折愈合,降低患者的并发症发生率,也能提高骨折复位质量,改善患者的总体疗效与肩关节功能。展开更多
The paper is devoted to dynamic design of thick orthotropic cantilever plates by applying the bimoment theory of plates, which takes into account the forces, moments and bimoments;and the theory takes into account non...The paper is devoted to dynamic design of thick orthotropic cantilever plates by applying the bimoment theory of plates, which takes into account the forces, moments and bimoments;and the theory takes into account nonlinear law of displacements distribution in cross section of the plate. The methods for constructing bimoment theory are based on Hooke’s Law, three-dimensional equations of the theory of dynamic elasticity and the method of displacements expansion into Maclaurin series. The article gives the expressions to determine the forces, moments and bimoments. Bimoment theory of plates is described by two unrelated two-dimensional systems with nine equations in each. On each edge of the plate, depending on the type of fastening, nine boundary conditions are given. As an example, the solution of the problem of dynamic bending of thick isotropic and orthotropic plate under the influence of transverse dynamic loads in the form of the Heaviside function is given. The equations of motion of the plate are solved by numerical method of finite differences. The numerical results are obtained for isotropic and orthotropic plate. The graphs of changes of displacements and stresses of faces surfaces of the plate are presented. Maximum values of these displacements are found and analyzed. It is shown that by Timoshenko theory numerical values of stresses are much smaller compared to the ones obtained by bimoment theory of plates. Maximum numerical values of generalized displacements, forces, moments, and bimoments are obtained and presented in tabular form. The analysis of numerical results is done and the conclusions are drawn.展开更多
文摘Clavicle fractures are among the most prevalent types of fractures with numerous treatment strategies that have evolved over time.In the realm of lateral-third clavicle fracture management,several surgical methods are available,with plate and screw constructs being one of the most frequently employed options.Within this construct,numerous choices exist for fixing the fracture.This editorial provides an overview of the common plate options utilized in the management of distal third clavicle fractures underscoring the critical considerations and approaches that guide clinicians in selecting the most appropriate fixation techniques,considering the complex landscape of clavicle fractures and their challenging management.
文摘Purpose: Acromioclavicular (AC) joint dislocation is commonly treated using a clavicle hook plate (HP). However, previous reports have indicated that acromial fractures may occur after HP fixation. The purpose of this study was to identify risk factors for acromial fractures. Methods: A retrospective study was conducted on 39 patients with AC joint dislocation who were treated using clavicle HP fixation in our hospital between 2006 and 2017. Related parameters, including Rockwood classification, hook angle, the degree of reduction, the coverage of the hook under the acromion, and the anteroposterior position of the hook under the acromion, were evaluated to identify risk factors for acromial fractures. Results: The mean age of the participants was 51.7 (range 19 - 81) years;34 were men and 5 were women. Injury occurred on the right side in 18 patients and on the left side in 21. Injuries were categorized as follows: 24 were Rockwood type III, one was type IV, and 14 were type V. Four of the 39 patients (10%) experienced acromial fractures. Statistical analyses indicated that the degree of reduction at the final follow-up was moderately correlated with the Constant score. Posterior positioning of the hook was the only identified risk factor for acromial fractures. Hook angle and the degree of reduction at the time of surgery were not significantly associated with acromial fractures. Conclusions: Postoperative shoulder function was associated with the degree of reduction at the final follow-up, suggesting that anatomical reduction is recommended for AC joint dislocation. Posterior positioning of the hook is a risk factor for acromial fractures;however, clavicle HP fixation provides a positive outcome for AC joint dislocation. Therefore, careful positioning of the hook is required for preventing acromial fractures.
基金Supported by Science Foundation Project of Baotou Medical College,No.BYJJ-YF-2018006.
文摘BACKGROUND For the treatment of distal clavicle fractures,each treatment method has its own advantages and disadvantages,and there is no optimal surgical solution.CASE SUMMARY Based on this,we report 2 cases of distal clavicle fractures treated utilizing an anterior inferior plate with a single screw placed in the distal,in anticipation of providing a better surgical approach to distal clavicle fracture treatment.Two patients were admitted to the hospital after trauma with a diagnosis of distal clavicle fracture,and were admitted to the hospital for internal fixation of clavicle fracture by incision and reduction,with good postoperative functional recovery.CONCLUSION With solid postoperative fixation and satisfactory prognostic functional recovery,this technique has been shown to be simple,easy to perform and effective.
文摘Background: Clavicular hook plates are effective fixation devices for lateral end clavicle fractures and acromioclavicular joint dislocations and have been extensively used in the last decade. Although this plate achieves a high percentage of union, there are concerns about sub-acromial osteolysis and impingement of supraspinatus tendon. Objective: To show that impingement of supraspinatus tendon can be prevented by measuring the depth between acromion and supraspinatus tendon posteriorly and using hook plates of appropriate depth. Materials and Methods: We performed a prospective study on 25 patients with lateral end clavicle fractures and acromio clavicular joint disruptions by measuring the depth between posterior border of acromion and the superior border of supraspinatus at the point of application of hook plate. Fixation is then done by appropriate sized hook plate. Results: None of the patients had impingement of supraspinatus tendon. Five patients developed subacromial osteolysis which did not have any impact on shoulder function. Conclusion: There is a variation in anatomy of the acromion in different ethnic groups. Hence uniform sized hook plate will be inappropriate. A smaller hook depth is needed in south Asian population to prevent impingement.
基金Non-Fund Project of Science and Technology of Zhanjiang(No.2019B01067)Competitive Allocation Program of Science and Technology Fund of Zhanjiang(No.2019A01029)。
文摘Objective:To investigate the mechanical properties of a new type of biplane locking plate with wings in the treatment of middle clavicle fractures.Methods:Based on the CT data of a healthy adult male volunteer’s clavicle,a three-dimensional finite element model of the middle clavicle fracture was constructed by digital three-dimensional reconstruction technology,and the two kinds of fixation methods of single-plane locking plate(SP)and wing plate(WP)were simulated.Four load cases of axial compression,axial torsion,cantilever bending and pull-out were used to analyze the models.Results:①Under axial compression,axial torsion,cantilever bending and pull-out conditions,compared with SP,the stiffness phase of WP increased by 1.47%,5.82%,1.51%and 3.96%respectively,and the strain energy decreased by 1.50%,5.39%,1.48%and 3.49%respectively.②The stress distribution characteristics of WP under various load conditions were similar to SP,and the high stress area was located around the screw hole of the steel plate above the fracture gap;③Under the pull-out condition of WP,the peak value of screw hole surface stress was greatly reduced compared with SP,especially in the screw hole on both sides of the wing screws,which had higher resistance to pull out.Conclusion:The load-bearing mode of WP under various load conditions is similar to that of SP,and the stability is slightly higher than that of SP and in terms of pull-out resistance,WP has more obvious advantages.The biplane locking plate with wings is expected to be a more ideal choice for patients with comminuted fracture of the middle clavicle or with osteoporosis.
文摘BACKGROUND Shoulder injuries caused by trauma are common,including clavicle fractures.Even so,bipolar segmental fracture of the clavicle is extremely rare and seldom reported.Therefore,there is still a controversial issue about how to treat these bipolar segmental clavicle fractures.CASE SUMMARY A 56-year-old security guard arrived at our emergency room after falling on his electric bicycle.There was no loss of consciousness or other pain.He had no numbness in his fingers.X-rays and 3D computed tomography revealed that the patient’s right shoulder had a bipolar segmental clavicle fracture.The surgical procedure included both open reduction and internal fixation.At the 1-year follow-up,he had a full range of motion and minimal discomfort in the injured shoulder.CONCLUSION We provide a rare case of bipolar clavicle facture in the right clavicle.We hold the opinion that such patients would get better clinical and radiological outcomes by early and correct operation.
基金Natural Science Foundation of Inner Mongolia Autonomous Region(2019MS08045).
文摘Objective:To explore the treatment of TOSSY type III acromioclavicular joint dislocation with clavicular hook plate combined with coracoclavicular ligament repair and its clinical effect.Methods:80 patients with TOSSY type III acromioclavicular joint dislocation who were admitted to our hospital from January 2014 to January 2019 were selected.They were randomly divided into the control group(n=39,treated with clavicular hook plate)and the observation group(n=41,treated with clavicular hook plate combined with coracoclavicular ligament repair)by the random number table method.The clinical efficacy in 12 months after operation,related clinical indicators,12-month postoperative recovery and postoperative complications were compared between the two groups.Results:The excellent and good rate was 92.68%(38/41)in 12 months after operation in the observation group,which was higher than that(76.92%,30/39)in the control group(p<.05).There were no significant differences in the duration of surgery,intraoperative blood loss and HLOS between the observation group and the control group(p>.05).In 12 months after operation,abduction activity and forward flexion activity of the observation group were higher than those of the control group,and visual analogue score(VAS)was lower than that of the control group(p<.05).The incidence of complications in the observation group was slightly lower than that in the control group,but there was no statistically significant difference between the two groups(p>.05).Conclusions:For TOSSY type III acromioclavicular joint dislocation,clavicular hook plate combined with coracoclavicular ligament repair has a good clinical efficacy.It can improve shoulder joint function,alleviate shoulder pain and have fewer complications.It can provide a reference for clinical treatment of this type of acromioclavicular joint dislocation.
文摘目的探讨与分析解剖钢板内固定系统和重建钢板固定治疗锁骨中段骨折的效果。方法选择2019年1月—2022年10月在苏州市吴江区第五人民医院入院并接受手术治疗的88例锁骨中段骨折患者作为研究对象,根据1:1随机掷骰子原则把88例患者分为解剖组44例与重建组44例。重建组给予重建钢板固定治疗,解剖组给予解剖钢板内固定系统治疗,记录与观察两组的治疗效果。结果两组术中出血量、手术时间、切口长度对比,差异无统计学意义(P>0.05),解剖组术后住院时间、术后切口愈合时间、术后骨折创面愈合时间与重建组对比有显著减少(P<0.05)。解剖组术后3个月的肩峰下撞击征、植入物松动、肩关节炎、切口感染、静脉血栓等并发症发生率为4.55%,重建组为20.45%,解剖组与重建组对比有明显降低(P<0.05)。解剖组术后3个月的骨折复位质量优良率为97.73%,显著高于重建组的84.09%(P<0.05)。解剖组术后3个月的总体疗效优良率为95.45%,与重建组的相比有显著提高81.82%(P<0.05)。两组术后3个月的Constant and Murley评分明显高于术前1 d(P<0.05),且解剖组术后3个月的Constant and Murley评分明显高于重建组(P<0.05)。结论相对于重建钢板内固定系统,解剖钢板内固定系统治疗锁骨中段骨折能促进患者的康复与骨折愈合,降低患者的并发症发生率,也能提高骨折复位质量,改善患者的总体疗效与肩关节功能。
文摘The paper is devoted to dynamic design of thick orthotropic cantilever plates by applying the bimoment theory of plates, which takes into account the forces, moments and bimoments;and the theory takes into account nonlinear law of displacements distribution in cross section of the plate. The methods for constructing bimoment theory are based on Hooke’s Law, three-dimensional equations of the theory of dynamic elasticity and the method of displacements expansion into Maclaurin series. The article gives the expressions to determine the forces, moments and bimoments. Bimoment theory of plates is described by two unrelated two-dimensional systems with nine equations in each. On each edge of the plate, depending on the type of fastening, nine boundary conditions are given. As an example, the solution of the problem of dynamic bending of thick isotropic and orthotropic plate under the influence of transverse dynamic loads in the form of the Heaviside function is given. The equations of motion of the plate are solved by numerical method of finite differences. The numerical results are obtained for isotropic and orthotropic plate. The graphs of changes of displacements and stresses of faces surfaces of the plate are presented. Maximum values of these displacements are found and analyzed. It is shown that by Timoshenko theory numerical values of stresses are much smaller compared to the ones obtained by bimoment theory of plates. Maximum numerical values of generalized displacements, forces, moments, and bimoments are obtained and presented in tabular form. The analysis of numerical results is done and the conclusions are drawn.
