Posterior Displacement and Angulation of Displaced Lateral Clavicle Fractures: Response

Authors’ Response:

We appreciate the interest in our article titled, “Posterior Displacement and Angulation of Displaced Lateral Clavicle Fractures: A 3-Dimensional Analysis,” ² and your comments in the letter to the editor. Indeed, our primary goal was to better understand the patterns of displacement and characteristics of distal clavicle fractures in order to achieve adequate reduction and fixation. For this purpose, we created a 3-dimensional model of distal clavicle fractures and performed a computational simulation of a virtual anatomic reduction. We would like to clarify your point of view as follows.

Regarding your comments, to some extent, we agree with you. Fracture displacement is traditionally defined in terms of the abnormal position of the distal fragment in relation to the proximal fragment. However, for the management of distal clavicular fractures, we should differentiate them from other fractures because they are mostly accompanied by coracoclavicular ligament injuries. In addition, these fractures have similar injury mechanisms and displacement patterns to acromioclavicular (AC) joint dislocation. Rockwood ^1,3 classified AC joint dislocations according to displacement patterns of the lateral clavicle, especially types III to IV. Thus, in our article, considering the AC joint dislocation, we described that most displaced lateral clavicle fractures have posterior displacement and angulation as well as superior displacement of the medial fragment. We presumed our description of distal clavicular fracture to be the same as AC joint dislocation.

To conclude, we appreciate your suggestions to improve the understanding of our article.

Chul-Hyun Cho, MD, PhD Beom-Soo Kim, MD, PhD Du-Han Kim, MD Daegu, Republic of Korea Gu-Hee Jung, MD, PhD Changwon-si, Republic of Korea