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Distal Clavicle Fracture Classification

Type I distal clavicle fracture

 

 

Type I

  • distal to the coracoclavicular ligaments.
  • Coracoclavicular ligaments remain intact,
  • Displacement uncommon.
  • Treatment = sling.
  1. Conoid ligament
  2. Trapezoid ligament
  3. Coracoid process
  4. Acromion
  5. Clavicle
Type IIA distal clavicle fracture

Type IIA

  • medial to the coracoclavicular ligaments.
  • Medial fragment frequently displaces superiorly.
  • Nonunion is frequent.
  • Treatment = ORIF. Consider hook-plate fixation (Haider SG, JSES 2006;15:419). Consider non-absorbable suture fixation. (Levy O, JSES 2003;12:24).
  1. Conoid ligament
  2. Trapezoid ligament
  3. Coracoid process
  4. Acromion
  5. Clavicle
Type IIB Distal Clavicle Fracture

Type IIB

  • Between the coracoclavicular ligaments.
  • Medial fragment frequently displaces superiorly.
  • Nonunion is frequent.
  • Treatment = ORIF. Consider hook-plate fixation (Haider SG, JSES 2006;15:419). Consider non-absorbable suture fixation. (Levy O, JSES 2003;12:24).
  1. Conoid ligament
  2. Trapezoid ligament
  3. Coracoid process
  4. Acromion
  5. Clavicle
Type III distal clavicle fracture

Type III

  • Intra-articular, frequently without ligament disruption.
  • Generally little or no displacement.
  • Frequently missed or misdiagnosed as acromioclavicular joint injuries.
  • May lead to AC arthritis.
  • Treatment = sling. Consider distal clavicle excision for patients who are symptomatic at 6-12 months after injury.
  1. Conoid ligament
  2. Trapezoid ligament
  3. Coracoid process
  4. Acromion
  5. Clavicle

 

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