Open reduction for late-presenting posterior dislocation of the elbow

S Mehta, A Sud, A Tiwari, SK Kapoor
Department of Orthopaedics, Lady Hardinge Medical College, New Delhi, India

PURPOSE. To assess the treatment outcome of temporary coracoclavicular screw fixation for displaced distal clavicle fractures.

METHODS. From January 1995 to December 2003, 30 consecutive patients with Neer type II displaced distal clavicle fractures were treated with open reduction and internal fixation using a coracoclavicular screw. The screw was removed under local anaesthesia after bony union. Patients were evaluated by clinical and radiological examination. Functional outcome was assessed by a simple shoulder test.

RESULTS. There was 100% union rate. All patients returned to their pre-injury activity level by 12 months. One patient developed a superficial wound infection, which resolved with oral antibiotics. Two patients had problems with mild backing out of the screw, but both had bony union by the time of screw removal. The mean score of the simple shoulder test of 28 patients was 11.

CONCLUSION. Treatment outcome using temporary coracoclavicular screw fixation for displaced distal clavicle fractures is favourable. The implant is readily available and the technique is simple, safe, cost-effective, and reproducible.