Clavicle hook plate fixation for distal-third clavicle fracture (Neer type II): comparison of clinical and radiologic outcomes between Neer types IIA and IIB

BACKGROUND: The purpose of this study was to evaluate the clinical outcomes and complications of hook plate fixation in acromioclavicular (AC) joint dislocations and distal clavicle fractures.METHODS: We retrospectively reviewed a series of 60 consecutive patients with hook plate fixation for AC joint dislocation (group I) and distal clavicle fracture (group II). Groups I and II had 39 and 21 patients, respectively. Clinical results were evaluated using the pain visual analogue scale (VAS), simple shoulder test, and Constant-Murley scores. In addition, subacromial erosion and stiffness were evaluated as complications.RESULTS: At the removal, the pain VAS was 2.69 ± 1.30 and 4.10 ± 2.14 in groups I and II, respectively, which were significantly different (p=0.003). The simple shoulder test score was 9.59 ± 1.60 and 7.81 ± 2.67 in groups I and II, respectively, which were also significantly different (p=0.002). Subacromial erosion was significantly more frequent in group II (14/21 patients, 66.7%) than in group I (15/39 patients, 38.5%) (p=0.037), and stiffness was also higher in group II (17/21 patients, 81.0%) than in group I (22/39 patients, 56.4%), but it was not significant.CONCLUSIONS: Hook plate fixation showed good clinical and functional results for the treatment of acute unstable AC joint dislocation and distal clavicle fracture. But, in distal clavicle fractures, there are more subacromial erosion and stiffness compare with acute unstable AC joint dislocation.

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Does Subacromial Osteolysis Affect Shoulder Function after Clavicle Hook Plating?

BioMed Research International ◽

10.1155/2016/4085305 ◽

2016 ◽

Vol 2016 ◽

pp. 1-5 ◽

Cited By ~ 4

Author(s):

Siwei Sun ◽

Minfeng Gan ◽

Han Sun ◽

Guizhong Wu ◽

Huilin Yang ◽

...

Keyword(s):

Clavicle Fracture ◽

Shoulder Function ◽

Hook Plate ◽

Acromioclavicular Joint Dislocation ◽

Lateral Clavicle Fracture ◽

Significant Difference ◽

Group A ◽

Group B ◽

Clavicle Hook Plate

Purpose.To evaluate whether subacromial osteolysis, one of the major complications of the clavicle hook plate procedure, affects shoulder function.Methods.We had performed a retrospective study of 72 patients diagnosed with a Neer II lateral clavicle fracture or Degree-III acromioclavicular joint dislocation in our hospital from July 2012 to December 2013. All these patients had undergone surgery with clavicle hook plate and were divided into two groups based on the occurrence of subacromial osteolysis. By using the Constant-Murley at the first follow-up visit after plates removal, we evaluated patients’ shoulder function to judge if it has been affected by subacromial osteolysis.Results.We have analyzed clinical data for these 72 patients, which shows that there is no significant difference between group A (39 patients) and group B (33 patients) in age, gender, injury types or side, and shoulder function (the Constant-Murley scores are93.38±3.56versus94.24±3.60,P>0.05).Conclusion.The occurrence of subacromial osteolysis is not rare, and also it does not significantly affect shoulder function.

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

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-019-1518-x ◽

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.

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The Clavicle Hook Plate for Neer Type II Lateral Clavicle Fractures

Journal of Orthopaedic Trauma ◽

10.1097/bot.0b013e318193d878 ◽

2009 ◽

Vol 23 (8) ◽

pp. 570-574 ◽

Cited By ~ 55

Author(s):

R J Renger ◽

G R Roukema ◽

J C Reurings ◽

P M Raams ◽

J Font ◽

...

Keyword(s):

Hook Plate ◽

Type Ii ◽

Lateral Clavicle ◽

Clavicle Fractures ◽

Clavicle Hook Plate

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Hook plate fixation for Neer's type II fracture of the lateral end of clavicle: Does it work?

Injury Extra ◽

10.1016/j.injury.2006.06.032 ◽

2007 ◽

Vol 38 (1) ◽

pp. 3

Author(s):

S.G. Haidar ◽

K.M. Krishnan ◽

S.C. Deshmukh

Keyword(s):

Plate Fixation ◽

Hook Plate ◽

Type Ii

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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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Neer Type II Distal End Clavicular Fracture: Outcome with Clavicular Hook Plate Fixation

Europasian Journal of Medical Sciences ◽

10.46405/ejms.v2i2.195 ◽

2020 ◽

Vol 2 (2) ◽

pp. 1-4

Author(s):

Sagar Panthi ◽

Rishiswor Shrestha ◽

Sabal Krishna Gaihre ◽

Angelica Karki ◽

Suyachha Chettri

Keyword(s):

Plate Fixation ◽

Adult Population ◽

Hook Plate ◽

Type Ii ◽

Clavicular Fracture ◽

Rare Type ◽

Non Union ◽

Excellent Outcome ◽

Clavicular Hook Plate

Background: Distal end clavicular fractures are rare type of injuries seen in adult population. These fractures are unstable because of various deforming forces. Clavicular hook plate aligns the clavicle along with ligaments. The aim of this study is to observe the outcome of displaced distal end clavicular fracture managed with hook plate fixation.Methods: Twenty five patients with displaced distal end clavicular fractures (Neer type II) were evaluated retrospectively from November 2018 to September 2020. Functional outcome were assessed via Constant and Murley score at one year final follow-up.Results: 60% of patient had excellent outcome, 32% of patient had good outcome and 8% of patient had fair outcome at final follow-up. Mean Constant and Murley score was 86. Four patients developed subacromial osteolysis which resolved at final follow-up. One patient had extra-articular ossification whereas none of the patient developed non-union and AC joint arthrosis.Conclusion: Clavicular hook plate provides stable fixation of distal end clavicular fracture with few complications and is cost-effective.Keywords: Clavicular Hook Plate; Complications; Distal End Clavicular Fractures; Subacromial Osteolysis

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