Lateral clavicular nonunion with intact coracoclavicular ligaments
10.1055/b-0034-86373
Lateral clavicular nonunion with intact coracoclavicular ligaments
René K Marti
Case description
A 35-year-old woman sustained a lateral clavicular fracture in a bicycle accident. Nine months later the fracture did not show any tendency to heal, still caused pain and only allowed limited shoulder function in daily activities. There was no progressive dislocation as is often seen when the coracoclavicular ligaments are torn as well (see case 2.1.4 “Lateral clavicular nonunion with torn coracoclavicular ligaments”).
a Oblique, atrophic nonunion of the lateral clavicle 9 months after the accident.b Lateral clavicular nonunion with preserved coracoclavicular ligament.
Indication
Nine months after the accident fracture healing cannot be expected without any intervention.
Preoperative planning
Equipment
K-wires
Cerclages wires
3.5 mm screws
(Size of system, instruments, and implants may vary according to anatomy.)
The oblique fracture allows anatomical reduction and 3.5 mm lag screw fixation, secured with a tension band, consisting of one K-wire and a figure-of-eight cerclage wire avoiding any damage to the acromioclavicular (AC) joint. Cancellous bone-graft harvesting may be necessary. X-ray 5 years postoperatively (b).
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