PMC5683890_01
Pre-Operative X- Ray Examination (A). Chest X-Ray Anterior-Posterior showed the widening Right sterno-clavicular joint and bone discontinuity of distal third right clavicle complete displaced, (B). Shoulder True AP X-Ray showed the widening of right acromio-clavicle and coracoclavicle distance. (C) Shoulder Scapular Y View X-Ray.
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Bone discontinuities of distal third clavicle Allman type II group IIB, coracoid Kuhn type II (Fig. 1), and the 1st, 2nd, 3rd, and 4th posterior aspect of right ribs were also demonstrated.
Pictures demonstrating intra-operative procedure and illustration during A. AC joint soft tissue reconstruction and osteosynthesis distal clavicle fracture B. SC joint soft tissue reconstruction.
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The graft, then, was inserted using the shuttle suture with the configuration as shown on the illustration (Fig. 2). The two parallel Kirschner wires were inserted from the acromion to the distal clavicle to maintain anteroposterior alignment (Fig. 2).
Post-Operative X ray. (A) Immediate Shoulder Anterior-Posterior (AP) X-Ray (B) 6-months post -operative Chest X-Ray (C) 6-months post-operative Shoulder AP X-Ray (D) 6-months-post-operarative Zanca View X-Ray.
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Plain radiographs at final follow-up showed a reduced SC and AC joints with union of the lateral end of clavicle fracture (Fig. 3). AC joint integrity, using axillary view (Fig. 3). ASES (American Shoulder and Elbow Surgeon) score at 6-months follow- up was good outcome (84/100) and the range of motion in the shoulder was normal with full range of abduction, elevation, and rotations (Fig. 4).
Range of Motion Examination 6 months after operation A. External Rotation of Shoulder Joint B. Elevation of Shoulder Joint C. Internal Rotation of Shoulder Joint.
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AC joint integrity, using axillary view (Fig. 3). ASES (American Shoulder and Elbow Surgeon) score at 6-months follow- up was good outcome (84/100) and the range of motion in the shoulder was normal with full range of abduction, elevation, and rotations (Fig. 4).
No Right Winged Scapula 6 months after surgery.
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We evaluated that there was no winged scapula, which probably could be caused by the sterno-clavicle-scapular linkage disruption (Fig. 5).