Hook versus locking plate fixation for Neer type-II and type-V distal clavicle fractures: a retrospective cohort study

Abstract Background The purpose of this meta-analysis was to compare clavicle hook plates versus distal clavicle locking plates for the treatment of Neer type II distal clavicle fractures. Methods PubMed (1996 to January 2019), Embase (1980 to January 2019), Web of Science (1990 to January 2019), the Cochrane Library (January 2019), and the China National Knowledge Infrastructure (January 2019) were systematically searched without language restrictions for literature retrieval. The Constant-Murley shoulder joint function score at 3 and 6 months after the operation and the postoperative complications after the operation (shoulder joint pain, abduction restriction, fracture delay healing, subacromial impingement) were the outcomes. Stata 12.0 was used for the meta-analysis. Results A total of 9 clinical trials involving 446 patients were finally included in this meta-analysis. The results showed that the improvement in the Constant-Murley shoulder joint function score in the distal locking plate group was better than that in the clavicle hook plate group at 3 and 6 months after the operation (P < 0.05). There were fewer cases of shoulder joint pain and restricted shoulder abduction range of motion in the distal locking plate group, and the difference was statistically significant (P < 0.05). There were no statistically significant differences in fracture delay healing and subacromial impingement between the two groups (P > 0.05). Conclusion Compared with the clavicular hook plate, the distal clavicle locking plate for the treatment of Neer type II distal clavicle fractures is associated with better shoulder function recovery and fewer complications related to pain and abduction restriction.

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Locking plate combined with titanium cable for Neer type II distal clavicle fractures

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04137-4 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Fan Zhang ◽

Qiang Fu ◽

Yongchuan Li ◽

Nan Lu ◽

Aimin Chen ◽

...

Keyword(s):

Complication Rate ◽

Locking Plate ◽

Type Ii ◽

Distal Clavicle ◽

Union Rate ◽

Clavicle Fractures ◽

The Mean ◽

One Year ◽

Distal Clavicle Fractures

Abstract Background There is controversy about the optimal strategy treatment of unstable distal clavicle fractures. We explored use of a surgical strategy: combination of a distal clavicle locking plate and a titanium cable. The purpose of this retrospective case series study was to evaluate the clinical outcomes of this new strategy in treating Neer type II distal clavicle fractures. Methods Twenty-one patients with Neer type II distal clavicle fracture were treated with a distal clavicle locking plate and a titanium cable. All patients were followed for at least one year. We retrospectively collected and reviewed follow-up data. The clinical outcomes were assessed for union rate, functional score, and complication rate. Results All patients achieved bony union within 6 months. The average follow-up period was 20.6 months (range12–48 months). The mean Constant score at one-year follow-up was 94.6 ± 3.3 (range 84–98), and the mean UCLA (University of California, Los Angeles) score was 33.3 ± 2.6 (range 27–35). Only one complication (wound infection) was observed during follow-up. Two patients received another operation for implant removal due to local irritation. Conclusions Use of a distal clavicle locking plate in combination with a titanium cable for treatment of Neer type II fractures results in high union rate, a low complication rate, and good shoulder function. This combined surgical strategy can be considered an effective method for treating unstable distal clavicle fractures.

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Treatment of distal clavicle fracture of Neer type II with locking plate in combination with titanium cable under the guide

Scientific Reports ◽

10.1038/s41598-021-84601-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Jun Wang ◽

Jie Guan ◽

Minbo Liu ◽

Yongfeng Cui ◽

Yuhang Zhang

Keyword(s):

Locking Plate ◽

Clavicle Fracture ◽

Operation Time ◽

Hook Plate ◽

Type Ii ◽

Distal Clavicle ◽

Distal Clavicle Fracture ◽

Plate Group ◽

Clavicle Fractures ◽

Distal Clavicle Fractures

AbstractTo observe and compare the curative effect of a locking plate plus titanium cable under the Guide device and clavicular hook plate in the treatment of Neer type II distal clavicle fractures. A prospective cohort study was conducted to analyse the clinical data of 36 patients with distal clavicle fractures from January 2016 to January 2019. The results were analysed. According to the random number method, the patients were divided into two groups: the titanium cable group (fixed with a titanium cable in combination with a locking plate) and hook plate group (fixed with a clavicular hook plate only). Under the guidance of a special device (for which a patent was obtained), in the titanium cable group, the coracoclavicular ligament was fixed with tension reduction, and then the distal clavicular fracture was fixed with a locking plate. In the hook plate group, the distal clavicle fracture was fixed with a hook plate. The incision length, operation time, bleeding volume and VAS score before, 1 week after and 1 year after the operation were compared between the two groups. The effect of the operation was evaluated by the Constant-Murley score before and 1 year after the operation. X-ray films were taken 2 days, 3 months, half a year and 1 year after the operation to observe the reduction and healing of fractures. At the same time, complications were recorded. The amount of bleeding was the same in the two groups. The operation time in the hook plate group was relatively short, and the difference was statistically significant (P < 0.05). The VAS score in the titanium cable group was significantly lower than that in the hook plate group one year after the operation. The Constant-Murley score in the titanium cable group and hook plate group was significantly higher 1 year after the operation. The number of postoperative complications in the titanium cable group was significantly lower than that in the hook plate group. The treatment of Neer type II distal clavicle fractures with a titanium cable plus a locking plate has a good curative effect, few complications and good postoperative recovery and thus is worth popularizing.

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