Addition of a Suture Anchor for Coracoclavicular Fixation to a Superior Locking Plate Improves Stability of Type IIB Distal Clavicle Fractures

2013 ◽  
Vol 29 (6) ◽  
pp. 998-1004 ◽  
Author(s):  
Wes Madsen ◽  
Zaneb Yaseen ◽  
Russell LaFrance ◽  
Tony Chen ◽  
Hani Awad ◽  
...  
Keyword(s):  
Locking Plate ◽  
Suture Anchor ◽  
Distal Clavicle ◽  
Clavicle Fractures ◽  
Coracoclavicular Fixation ◽  
Distal Clavicle Fractures

scholarly journals Comparison of the efficacy of a distal clavicular locking plate with and without a suture anchor in the treatment of Neer IIb distal clavicle fractures

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Hua Xu ◽  
Wen Jun Chen ◽  
Xiao Cheng Zhi ◽  
Shi Chang Chen
Keyword(s):  
Clinical Outcomes ◽  
Locking Plate ◽  
Suture Anchor ◽  
Early Stage ◽  
Locking Plates ◽  
Suture Anchors ◽  
Distal Clavicle ◽  
Application Procedure ◽  
Clavicle Fractures ◽  
Distal Clavicle Fractures

Abstract Background To compare the clinical outcomes between the use of a distal clavicular locking plate alone and the combined use of a plate and a coracoclavicular suture anchor in the treatment of Neer IIb distal clavicle fractures and to discuss the application procedure of suture anchors. Methods This is a retrospective study. Thirty-four patients with unilateral Neer IIb distal clavicle fractures who underwent open reduction and internal fixation with a distal clavicular locking plate only (16 patients) or with both a plate and a coracoclavicular suture anchor (18 patients) were evaluated. The main observation data included the Constant-Murley Shoulder Function Score (CMS), rate of postoperative complications, and union time. Results The distal clavicular locking plate and coracoclavicular suture anchor combination group had better outcomes in the Constant-Murley score (94.6 ± 4.5 vs. 90.1 ± 9.5) (P < 0.05) and a shorter union time (13.9 ± 2.3 vs. 16.1 ± 3.0) (P < 0.05) than the locking plate only group did, and the rate of complications showed no significant difference, 16.7% vs. 31.2% (5/16) (P>0.05). Conclusions Both methods achieved good results in the treatment of Neer IIb distal clavicle fractures; however, the use of both locking plates and coracoclavicular suture anchors can provide more stability in the early stage after operation than can the use of locking plates alone, which can make the sped of union quicker and result in better clinical outcomes. For elderly patients with comminuted Neer IIb distal clavicle fractures, a locking plate combined with a suture anchor is recommended to provide more stability in the early stage after the operation.

scholarly journals Comparative analysis of a locking plate with an all-suture anchor versus hook plate fixation of Neer IIb distal clavicle fractures

2020 ◽  
Vol 28 (3) ◽  
pp. 230949902096226
Author(s):  
Joong-Bae Seo ◽  
Kwon-young Kwak ◽  
Jae-Sung Yoo
Keyword(s):  
Suture Anchor ◽  
Constant Score ◽  
Plate Fixation ◽  
Distal Clavicle ◽  
Level Of Evidence ◽  
Fixation Group ◽  
Clavicle Fractures ◽  
Suture Anchor Fixation ◽  
Anchor Fixation ◽  
Distal Clavicle Fractures

Background: The coracoclavicular fixation with suture anchors adds stability to type IIb distal clavicle fractures fixed with a plate and screws when loaded to failure. The purpose of this study was to compare the clinical and radiological outcomes between the use of a locking compression plate (LCP) with all-suture anchor fixation and hook LCP fixation of Neer IIb distal clavicle fractures. Methods: A total of 82 consecutive patients who underwent plate fixation for Neer IIb distal clavicle fractures were included. The subjects were divided into two groups: an LCP with all-suture anchor fixation group and hook LCP fixation group. For clinical assessments, the American Shoulder and Elbow Surgeons score, Korean shoulder score (KSS), and Constant score were recorded. A percentage of the coracoclavicular distance (CCD%) was used to evaluate fracture reduction. Typical reported complications, such as secondary dislocation, implant failure or loosening, peri-implant fracture, acromion osteolysis, stiffness, peri-anchor osteolysis, postoperative acromioclavicular joint arthrosis, nonunion, or delayed union, were also analyzed. Results: There were no differences in the clinical and radiological outcomes at the final follow-up between the two groups. The period for bone union and CCD% showed no significant differences between groups. Stiffness at 3 months after surgery of LCP with all-suture anchor fixation ( n = 3, 10.7%) was less than that of hook LCP fixation ( n = 17, 31.5%). The complication rate also showed no significant differences between groups. However, LCP with all-suture anchor fixation had anchor-related complications, although it can reduce hook-related complications. Conclusion: LCP with all-suture anchor fixation showed satisfactory outcomes in comparison with hook LCP fixation. In Neer IIb distal clavicle fractures, LCP with all-suture anchor fixation is a useful method for the maintenance of reduction, avoiding implant removal, and hook-related complications. However, anchor fixation should be carefully used, especially in osteoporotic patients or patients with underlying diseases. Level of Evidence: Level III, retrospective study.

scholarly journals Clavicle hook plate versus distal clavicle locking plate for Neer type II distal clavicle fractures

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Liang Li ◽  
Tian-yan Li ◽  
Peichao Jiang ◽  
Guizhen Lin ◽  
Hongxiao Wu ◽  
...  
Keyword(s):  
Shoulder Joint ◽  
Locking Plate ◽  
Meta Analysis ◽  
Hook Plate ◽  
Type Ii ◽  
Distal Clavicle ◽  
Plate Group ◽  
Clavicle Fractures ◽  
Distal Clavicle Fractures ◽  
Clavicle Hook Plate

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.

Anatomic Locking Plate Fixation and Coracoclavicular Stabilisation with Multistrand Titanium Cable for Unstable Distal Clavicle Fracture

2021 ◽  
Vol 11 (5) ◽  
pp. 1477-1480
Author(s):  
Zhong-Guo Liu ◽  
Yue-Wei Yu ◽  
Huang-Lin Xie ◽  
Qing-Xin Xie
Keyword(s):  
Fracture Healing ◽  
Locking Plate ◽  
Clavicle Fracture ◽  
Clinical Effects ◽  
Distal Clavicle ◽  
Distal Clavicle Fracture ◽  
Clavicle Fractures ◽  
Anatomic Locking Plate ◽  
Distal Clavicle Fractures

Objective: The aim of this study was to introduce a modified surgical procedure using anatomic locking plate (ALP) fixation and coracoclavicular (CC) stabilisation with multistrand titanium cable (MTC) to repair unstable distal clavicle fractures, and to estimate clinical effects of these people. Materials and methods: Between July 2016 and April 2018, we treated 7 patients with unstable distal clavicle fracture by ALP fixation and CC stabilisation with MTC. After the surgery, we followed up every patient for at least 24 months and analysed their clinical results. Results: The average term required for fracture healing was 9.9 (range, 9–12 weeks) and all cases are successful in fracture healing. The average Constant score was 94.6 points (range, 92–100) at the last follow-up; the modified University of California, Los Angeles (UCLA) shoulder rating scale was 33.4 points (range, 31–35) at the last follow-up. There was no infection, hardware failure and iatrogenic fracture in all the cases. Conclusions: ALP fixation and CC stabilisation with MTC is a really good method for the treatment of unstable distal clavicle fractures. This surgical technique can provide stable fixation for early functional exercise, and prevent extra shoulder joint damage.

scholarly journals Treatment of unstable distal clavicle fractures (Neer type IIb): a modified system using a miniature locking plate with a single button

2021 ◽  
Vol 49 (6) ◽  
pp. 030006052110225
Author(s):  
Hua Ying ◽  
Jihuan Wang ◽  
Yuehua Sun ◽  
Kerong Dai ◽  
Chao Yu ◽  
...  
Keyword(s):  
Los Angeles ◽  
Locking Plate ◽  
Constant Score ◽  
Shoulder Injuries ◽  
Distal Clavicle ◽  
Clavicle Fractures ◽  
The Mean ◽  
Neer Type Iib ◽  
Distal Clavicle Fractures

Distal clavicle fractures are common in patients with shoulder injuries. We retrospectively evaluated the clinical outcomes of a novel fixation technique using a miniature locking plate with a single button in patients with distal clavicle fractures associated with coracoclavicular ligament disruption. The study involved seven patients with distal clavicle fractures with a follow-up period of 12 months. All patients were diagnosed with type IIb fractures according to the Neer classification. The distal clavicle fracture was fixed with a miniature locking plate, and the coracoclavicular ligaments were reconstructed using a single button. Functional outcomes were assessed at the final follow-up visit. At the 1-year follow-up, all patients had achieved radiographic union. There were no cases of nonunion or osteolysis. The mean Constant score at the final follow-up was 88 ± 5.13 (range, 78–93); the mean Disabilities of the Arm, Shoulder and Hand score was 19.17 ± 7.70 (range, 11.67–25); and the mean University of California Los Angeles score was 30 ± 2.52 (range, 25–33). In summary, internal fixation using a miniature locking plate and coracoclavicular reconstruction with a single button is a reliable surgical technique for restoring stability in patients with Neer type IIb distal clavicle fractures.

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