SCJ injury- New Surgical Technique
Thomas D. Tennent, Eyiyemi O. Pearse, Deborah M. Eastwood,
A New Technique For Stabilising Adolescent Posteriorly displaced Medial Physeal Clavicular Fractures
Journal of Shoulder and Elbow Surgery, Volume 21, Issue 12, December 2012, Pages 1734-1739,
Adolescent posteriorly displaced physeal injuries of the medial clavicle are uncommon. Up to 50% of conservatively treated patients remain symptomatic, and late surgery is hazardous. Stability is rarely achieved with closed or open reduction alone, and internal fixation is usually required. Previously described options for fixation achieve stability of the medial clavicle by securing it to the intact epiphysis. Because the epiphyseal fragment is small, fixation is achieved using sutures or wires. This relies on the size and structural integrity of the medial fragment, which in our experience can be variable. We hypothesized that a novel technique of operative stabilization of these injuries, which does not require fixation to the epiphyseal fragment and uses no metalwork, is safe and effective in treating these injuries.
Materials and methods
The operative technique involves suturing the medial clavicle to the anterior platysmal and periosteal layer using absorbable sutures passed through drill holes in the medial clavicle. Patients were assessed clinically an average of 9 months after surgery.
We treated 7 patients with this method. There were no intraoperative complications. All patients were pain-free and symptom-free and had a full range of movement at follow-up. All patients had returned to their preinjury level of sports.
We recommend this technique for treating these uncommon injuries. It is simple, safe, and reproducible and it produces good results.