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Introduction: the use of coracoclavicular augmentation systems together with locking plates in the treatment of unstable distal clavicle fractures (Neer II and Neer V) is controversial., Material and Methods: patients with unstable distal clavicle fractures treated between 2013-2022 were retrospectively reviewed. The patients were divided into two groups: patients treated with locking plates (P group) and patients treated with locking plates and coracoclavicular augmentation systems (PCC group). Postoperative complications, modified preoperative and final coracoclavicular distance (CC), and outcomes on the Visual Analog Scale (VAS) and Quick Disabilities of the Arm, Shoulder, and Hand (Quick DASH) were recorded., Results: 16 of 23 patients were treated with plates only, and 7 of 23 were treated with plates and coracoclavicular augmentation systems. One case showed no fracture consolidation, and there was one case of cutaneous infection. The mean final CC distance was 23.7 in the P group and 22.1 in the PCC group. The mean VAS score was 1.3 in both the P and PCC groups, while the mean Quick DASH score was 5.5 in the P group and 8.1 in the PCC group. No significant differences were found in CC distance, VAS or Quick DASH scores., Conclusion: the use of locking plates is likely sufficient in the management of unstable distal clavicle fractures, as there were no significant differences in functional outcomes in this study when coracoclavicular augmentation systems were used together with locking plates.

Objective: To report our experience in the treatment of 2-3 fragment proximal humeral fractures using a minimally invasive technique that involves an angular-stable locking implant and find out the factors affecting patients outcomes., Material and Methods: Descriptive, prospective study of the case series type. Twenty-two patients, 13 females and 9 males, were operated on between February 2010 and August 2012. Mean age was 50.8 years (24-82 years). Patients were placed in a beach-chair position. A lateral acromial approach was used under fluoroscopic guidance. Minimal follow-up period was 24.3 months (11-32). Follow-up consisted of X-ray review to check for bone healing and avascular necrosis, and functional assessment using the Constant-Murley scale., Results: Bone healing occurred in all cases at 6 months. There were no cases of avascular necrosis. Two patients had varus healing (109º), and two had plate impingement. The functional assessment score according to the Constant-Murley scale was 68.8. There were no associated neurologic lesions., Conclusions: Fixation of proximal humeral fractures with a minimally invasive technique using locking plates represents a valid surgical approach. The avascular necrosis rate was low and early rehabilitation was possible in patients with poor bone quality.

Objective: To study the causes and outcomes of patients with interprosthetic femoral fractures., Material and Methods: A retrospective review conducted on 7 patients treated between 2010 and 2013. The knee arthroplasties had been implanted for at least 5 years, and those of the hip less than a year. They were bipolar cemented in 6 patients and totally non-cemented in one patient, all of them implanted due to a displaced femoral neck fracture. They were treated using osteosynthesis with angular stability plate covering the whole interprosthetic femoral segment. Except for one patient, all have been reviewed at least 12 months., Results: The patients included 6 women and one man, with a mean age of 84.7. The fracture, always by low energy, occurred between 2 and 8 months after that of the hip without the implants being mobilized. Four of them were located at diaphyseal level, and 3 at supracondylar level, and unrelated to the type of knee implant. There was consolidation in all patients at a mean of 4.5 months, without a re-operation in any of them, and with no mortality during the follow-up period. All patients walked independently at the time of the fracture, and all of them have managed to return to walking independently, having lost as average 20° of knee flexion in cases of supracondylar fracture., Conclusions: The most important factors in our patients regarding the producing of the fracture have been the changes in the ability to walk after knee replacement and bone fragility. Angular stability plates give good results in the treatment of interprosthetic femoral fractures., (Copyright © 2016 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: To analyze the outcomes of distal tibia fractures with or without extension into the ankle joint, treated by percutaneous cannulated screws or locking plates., Material and Method: A retrospective study was conducted on 107 patients treated between 2001 and 2012., Inclusion Criteria: fractures 43-A and 43-C1 and C2 according to the AO/OTA system, treated with percutaneous osteosynthesis by locking plate or two cannulated screws in X -letter setting. A total of 33 patients were evaluated: 16 tibial fractures were performed with locking plate (G1) and 17 with cannulated screws (G2). Mean time to surgery was 8.31 days (0-14) in G1, and 2 days (0-7) in G2. The mean follow-up was 72 months (12-132). Mean time to healing: 17.08 weeks (8-48) in G1, and 14.56 weeks (8-24) in G2. The results were evaluated according to the AOFAS scale, with plain X-rays, and complications during follow-up., Results: The mean evaluation according to the AOFAS score was 78.62 in G1 (22-93), and 90.63 in G2 (70-100), and this was statistically significant. In G1, 61.4% (8) of the results were excellent or good, while in G2 it was 76% (13). There were no axial deformity cases or shortenings. There were 4 superficial infections and one broken device recorded in G1., Discussion: The percutaneous cannulated screw fixation is a suitable alternative for the management of fractures without significant joint involvement, and seems to offer better functional results than plates. The shortest time from injury to intervention in this group improves the progress of the soft tissues, and can improve the final result., (Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.)