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. 2021 Oct:87:106411.
doi: 10.1016/j.ijscr.2021.106411. Epub 2021 Sep 15.

Peri-implant distal clavicle fracture: Case report (overlaying plate fixation: Solution for peri-implant clavicle fractures)

Guilherme Vieira Lima  1 , Nataniel Sousa Santos Filho  2 , Cézar Augusto Pimentel Furlan  2 , Joel Murachovsky  3 , Vitor La Banca  3 , Roberto Yukio Ikemoto  3
Affiliations

Peri-implant distal clavicle fracture: Case report (overlaying plate fixation: Solution for peri-implant clavicle fractures)

Guilherme Vieira Lima et al. Int J Surg Case Rep. 2021 Oct.

Abstract

Introduction and importance: Surgical treatment for clavicle injuries is indicated for displaced and shortened fractures. Osteosyntheses with plate fixation may present with complications in 6.3% to 8.5% of patients. Peri-implant clavicle fractures (PIF) are rare, and we have not found any previous cases in our literature search.

Case presentation: A 25-year-old male with previously (six years earlier) surgically treated clavicle fracture presented with a peri-implant clavicle fracture requiring surgical treatment. The management involved overlaying an implant to fix the lateral clavicle fracture without removing the previous plate. Complete bone healing was observed without any further complication.

Clinical discussion: Despite the low rate of implant failure in clavicle fractures, this complication occurs mainly in elderly patients with poor bone quality. No PIF have been described in the literature prior to this. This case report demonstrates a young patient with good bone quality and previous fracture fixation presenting with PIF which has now shown complete bone healing.

Conclusion: In this case, overlying an additional plate on the lateral clavicle portion without removing the previous plate increased the stability of the fracture. It demonstrates the value of overlaying plate osteosyntheses for patients with clavicle PIF.

Keywords: Bone plate; Case report; Clavicle; Complications; Fracture; Osteosyntheses.

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Conflict of interest statement

None of the authors has any conflict of interest to disclose.

We confirm that we have read the Journal's position on issues involved in ethical publication and affirm that this report is consistent with those guidelines.

Figures

Fig. 1
Fig. 1
Initial radiographic exam with PIF of the distal third of the clavicle.
Fig. 2
Fig. 2
a) Intraoperative image of the fracture with previous plate. b) Final fixation with the overlaying lateral plate and non-absorbable suture.
Fig. 3
Fig. 3
Radiograph at 3-month follow-up showing complete bone healing.
Fig. 4
Fig. 4
Clinical results at the one-year follow-up. Complete recovery of the elevation, external and internal rotation of the shoulder.
See this image and copyright information in PMC

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