Open reduction and internal fixation in treatment of four cases of bipolar clavicle dislocations_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

GAO Peigang , WANG Xingcun ,  BAO Honggang

Department of Orthopedics, Air Force Hospital of Central Theater Command of Chinese PLA, Datong Shanxi, 037006, P. R. China;

Corresponding?author：

BAO Honggang, Email: 2132965316@qq.com

Keywords：

Bipolar clavicle dislocation; sternoclavicular joint; acromioclavicular joint; open reduction; internal fixation

DOI：

10.7507/1002-1892.202311050

Video：

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Objective To summarize the method and effectiveness of open reduction and internal fixation in the treatment of 4 cases of bipolar clavicle dislocations. Methods Between June 2017 and June 2022, 4 patients with bipolar clavicle dislocations were admitted. There were 3 males and 1 female. The age ranged from 27 to 63 years, with an average age of 45 years. There were 2 cases of crushing injury of mine car, 1 case of traffic accident injury, and 1 case of heavy object injury. The time from injury to operation was 3-7 days, with an average of 5.0 days. The sternoclavicular joint dislocations were classified as Grade Ⅱ in 1 case and type Ⅲ in 3 cases, and anterior dislocation in 3 cases and posterior dislocation in 1 case. The acromioclavicular joint dislocations were classified as Tossy type Ⅱ in 2 cases and type Ⅲ in 2 cases. After open reduction, the sternoclavicular joint and acromioclavicular joint were fixed with lateral malleolus locking titanium plate and clavicular hook plate, respectively. Results All operations were successfully completed without vascular or nerve injury. All incisions healed by first intention. All patients were followed up 12-18 months, with an average of 14 months. At last follow-up, the shoulder joint functions were rated as excellent in 3 cases and good in 1 case according to Rockwood score. During follow-up, there was no loosening of internal fixator or fracture. The internal fixators were removed in all patients at 5-7 months after operation (mean, 6 months), and no re-dislocation occurred after removal. Conclusion For bipolar clavicle dislocation, open reduction combined with lateral malleolus locking titanium plate fixation of the sternoclavicular joint and clavicle hook plate fixation of the acromioclavicular joint can achieve good effectiveness. It has the advantages of simple operation, high safety, firm fixation, and fewer complications, and the shoulder function recovers well.

Citation： GAO Peigang, WANG Xingcun, BAO Honggang. Open reduction and internal fixation in treatment of four cases of bipolar clavicle dislocations. Chinese Journal of Reparative and Reconstructive Surgery, 2024, 38(2): 151-154. doi: 10.7507/1002-1892.202311050 Copy

1.	滕繼平, 倪達. 創傷性胸鎖關節脫位的治療. 創傷外科雜志, 2021, 23(9): 641-645.
2.	周金華, 張文璽, 劉國旗, 等. 雙平面固定胸鎖關節前方不穩定性骨折脫位的臨床療效. 中華肩肘外科電子雜志, 2021, 9(2): 136-141.
3.	Naquira Escobar LF, Duque Tobon JJ, Barrera Correa J. Surgical treatment for sternoclavicular joint dislocations. Trauma Case Rep, 2022, 40: 100645.
4.	周定凱, 訾成毅, 趙紫楊, 等. 橋接組合式內固定系統治療胸鎖關節脫位初步臨床療效. 昆明醫科大學學報, 2022, 43(6): 56-62.
5.	陳紅俊, 胡栢均, 高大偉, 等. 鎖骨鉤鋼板固定術后肩峰下骨溶解的相關因素與不良影響的研究. 實用骨科雜志, 2023, 29(6): 532-536.
6.	丁二虎, 盧弘栩, 戴永平, 等. 肩鎖關節脫位手術治療進展. 世界最新醫學信息文摘, 2021, 21(53): 57-59.
7.	張尚省, 楊果, 胡捷斯, 等. 胸鎖關節脫位伴同側肩鎖關節脫位1例. 臨床骨科雜志, 2022, 25(5): 613.
8.	王濤, 婁園一, 陳周韜, 等. 喙鎖韌帶重建術和鎖骨鉤鋼板治療不穩定型鎖骨遠端骨折效果的Meta分析. 廣西醫學, 2023, 45(15): 1871-1878.
9.	許健, 康運康, 畢文智, 等. TightRope聯合Locking-Loop 雙平面解剖重建技術治療急性肩鎖關節脫位. 中國修復重建外科雜志, 2023, 37(3): 257-263.
10.	傅明輝, 鄭興國, 薛騁, 等. 原止點解剖重建喙鎖韌帶與鎖骨鉤鋼板固定治療肩鎖關節脫位的療效比較. 中華骨科雜志, 2023, 43(14): 951-958.
11.	孫王平, 伍海昭, 張傳毅, 等. 急性胸鎖關節脫位的治療進展. 中國現代醫生, 2022, 60(34): 120-122.
12.	Wagner RJ, Symanski JS, Raasch WG, et al. Successful nonsurgical management of a posteriorly displaced medial clavicular physeal fracture in an adolescent athlete: a case report. Clin J Sport Med, 2022, 32(3): e319-e321.
13.	Portale J. Persistent shoulder pain after fall: posterior dislocation of the sternoclavicular joint. J Emerg Med, 2020, 58(3): 512-513.
14.	Albors LM, Lee RJ. Chronic posterior sternoclavicular dislocation in a contact athlete: a case report. JBJS Case Connect, 2020, 10(1): e0032.
15.	Qu Y, Xie X, Zhou W, et al. Operative treatment outcomes of anterior sternoclavicular joint dislocation using two experimental methods—an acromioclavicular joint hook plate versus a locking plate: a retrospective study. BMC Musculoskelet Disord, 2022, 23(1): 350.
16.	蔡國平, 徐春麗, 鄧波, 等. 胸鎖鉤鋼板治療鎖骨近端骨折伴胸鎖關節脫位. 中國骨傷, 2021, 34(6): 563-567.
17.	于健, 申屠剛, 王朋飛, 等. 雙Endobutton帶袢鋼板內固定治療Ⅲ度胸鎖關節脫位的療效分析. 中國骨與關節損傷雜志, 2023, 38(3): 306-307.
18.	周繼輝, 李新志, 周游, 等. 創傷性胸鎖關節脫位多種內置物治療優劣的比較. 中國組織工程研究, 2021, 25(3): 443-448.
19.	Keohane D, Morrissey D. Repair of sternoclavicular joint ligament: a novel approach. Ir J Med Sci, 2022, 191(5): 2141-2145.

1. 滕繼平, 倪達. 創傷性胸鎖關節脫位的治療. 創傷外科雜志, 2021, 23(9): 641-645.
2. 周金華, 張文璽, 劉國旗, 等. 雙平面固定胸鎖關節前方不穩定性骨折脫位的臨床療效. 中華肩肘外科電子雜志, 2021, 9(2): 136-141.
3. Naquira Escobar LF, Duque Tobon JJ, Barrera Correa J. Surgical treatment for sternoclavicular joint dislocations. Trauma Case Rep, 2022, 40: 100645.
4. 周定凱, 訾成毅, 趙紫楊, 等. 橋接組合式內固定系統治療胸鎖關節脫位初步臨床療效. 昆明醫科大學學報, 2022, 43(6): 56-62.
5. 陳紅俊, 胡栢均, 高大偉, 等. 鎖骨鉤鋼板固定術后肩峰下骨溶解的相關因素與不良影響的研究. 實用骨科雜志, 2023, 29(6): 532-536.
6. 丁二虎, 盧弘栩, 戴永平, 等. 肩鎖關節脫位手術治療進展. 世界最新醫學信息文摘, 2021, 21(53): 57-59.
7. 張尚省, 楊果, 胡捷斯, 等. 胸鎖關節脫位伴同側肩鎖關節脫位1例. 臨床骨科雜志, 2022, 25(5): 613.
8. 王濤, 婁園一, 陳周韜, 等. 喙鎖韌帶重建術和鎖骨鉤鋼板治療不穩定型鎖骨遠端骨折效果的Meta分析. 廣西醫學, 2023, 45(15): 1871-1878.
9. 許健, 康運康, 畢文智, 等. TightRope聯合Locking-Loop 雙平面解剖重建技術治療急性肩鎖關節脫位. 中國修復重建外科雜志, 2023, 37(3): 257-263.
10. 傅明輝, 鄭興國, 薛騁, 等. 原止點解剖重建喙鎖韌帶與鎖骨鉤鋼板固定治療肩鎖關節脫位的療效比較. 中華骨科雜志, 2023, 43(14): 951-958.
11. 孫王平, 伍海昭, 張傳毅, 等. 急性胸鎖關節脫位的治療進展. 中國現代醫生, 2022, 60(34): 120-122.
12. Wagner RJ, Symanski JS, Raasch WG, et al. Successful nonsurgical management of a posteriorly displaced medial clavicular physeal fracture in an adolescent athlete: a case report. Clin J Sport Med, 2022, 32(3): e319-e321.
13. Portale J. Persistent shoulder pain after fall: posterior dislocation of the sternoclavicular joint. J Emerg Med, 2020, 58(3): 512-513.
14. Albors LM, Lee RJ. Chronic posterior sternoclavicular dislocation in a contact athlete: a case report. JBJS Case Connect, 2020, 10(1): e0032.
15. Qu Y, Xie X, Zhou W, et al. Operative treatment outcomes of anterior sternoclavicular joint dislocation using two experimental methods—an acromioclavicular joint hook plate versus a locking plate: a retrospective study. BMC Musculoskelet Disord, 2022, 23(1): 350.
16. 蔡國平, 徐春麗, 鄧波, 等. 胸鎖鉤鋼板治療鎖骨近端骨折伴胸鎖關節脫位. 中國骨傷, 2021, 34(6): 563-567.
17. 于健, 申屠剛, 王朋飛, 等. 雙Endobutton帶袢鋼板內固定治療Ⅲ度胸鎖關節脫位的療效分析. 中國骨與關節損傷雜志, 2023, 38(3): 306-307.
18. 周繼輝, 李新志, 周游, 等. 創傷性胸鎖關節脫位多種內置物治療優劣的比較. 中國組織工程研究, 2021, 25(3): 443-448.
19. Keohane D, Morrissey D. Repair of sternoclavicular joint ligament: a novel approach. Ir J Med Sci, 2022, 191(5): 2141-2145.

Chinese Journal of Reparative and Reconstructive Surgery

Open reduction and internal fixation in treatment of four cases of bipolar clavicle dislocations

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