- 期刊
- OpenAccess
Incidental acromioclavicular joint separation after osteosynthesis operation of midshaft clavicle fracture: A latent concomitant injury
摘要
Introduction: Little research reported concomitant ipsilateral midshaft clavicle fracture and acromioclavicular (AC) joint injury, and even little research focused on AC joint injuries found after clavicle osteosynthesis. Purpose: This study investigated the etiology and risk factors for incidental AC joint separation after midshaft clavicle fracture osteosynthesis. Methods: We retrospectively reviewed medical records of patients who received internal fixation of midshaft clavicle fracture at our hospital in 2019. The data included patient demographics, fracture patterns, injury severity, associated injuries, and perioperative data. Serial pre- and postoperative plain radiographs were reviewed. AC joint separation was evaluated by D/A ratio and classified into normal, subluxation (0 ＜ D/A ≤ 0.5), and dislocation (D/A ＞ 0.5). Results: Among 140 patients who underwent internal fixation for midshaft clavicle fractures, 20 (14.2%) postoperatively presented with incidental AC joint separations; 14 had AC joint subluxation, whereas the other 6 had dislocation. The rate of incidental postoperative AC joint separation was significantly higher in patients with AO/OTA type B (28.5%) midshaft clavicle fractures compared to those with type A (9.2%) or type C (10.0%) fractures (p = 0.020). Using a pre-contoured locking plate fixation (odds ratio, 3.13; p = 0.160), and a longer time between injury and surgery (odds ratio, 1.07; p = 0.066) revealed an increasing tendency of having this injury. No significant association was observed between patient demographic data, having multiple traumas, the injured side, or injury mechanism with incidental AC joint separation. Conclusions: We found a higher incidence of AC joint separation after clavicle osteosynthesis in this study compared to previous reports. A latent AC joint separation is difficult to diagnose preoperatively but can be observed after clavicle osteosynthesis. Conducting thorough physical examinations and radiographic evaluation before, during, and after clavicle osteosynthesis can improve early recognition of the concomitant injury.
延伸閱讀
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