Treatment of unstable distal clavicle fractures (Neer type II): A comparison of three internal fixation methods

Objective This study was performed to compare the clinical efficacy of three internal fixation methods for distal clavicle fractures (Neer type II): clavicular hook plate (Group A), anatomical plate (Group B), and arthroscopic Endobutton (Group C). Methods From 2001 to 2014, 58 patients with Neer type II distal clavicle fractures were treated at our institution. The clinical results were assessed with the visual analog scale (VAS), Constant score, and Simple Shoulder Test (SST) score. Results All patients had anatomic reduction and bone healing at the final follow-up. Groups B and C had considerably less intraoperative blood loss than Group A. The incision was significantly shorter in Group C than in Groups A and B. The mean VAS score was significantly higher in the affected than unaffected shoulder. The Constant and SST scores were significantly higher in the unaffected than affected shoulder. The VAS, Constant, and SST scores of the affected shoulders were not significantly different among the three groups. Conclusions Arthroscopic Endobutton fixation has long-term clinical results similar to those of other surgical protocols for distal clavicle fractures (Neer type II). We recommend this technique because of less blood loss, shorter incision length, and less shoulder irritation than other methods.

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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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Clinical Results of Treatment Using a Clavicular Hook Plate Versus a T-plate in Neer Type II Distal Clavicle Fractures

Orthopedics ◽

10.3928/01477447-20120725-18 ◽

2012 ◽

Vol 35 (8) ◽

pp. e1191-e1197 ◽

Cited By ~ 31

Author(s):

Hong-Lve Tan ◽

Jin-Kun Zhao ◽

Chen Qian ◽

Yan Shi ◽

Qi Zhou

Keyword(s):

Clinical Results ◽

Hook Plate ◽

Plate Versus ◽

Type Ii ◽

Distal Clavicle ◽

Results Of Treatment ◽

Clavicular Hook Plate ◽

Clavicle Fractures ◽

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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Comparison of the effect of two internal fixation methods for proximal clavicle fractures

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.66.5.654 ◽

2020 ◽

Vol 66 (5) ◽

pp. 654-658

Author(s):

Haining Xu ◽

Yan Nie ◽

Lifang Han ◽

Liang Li ◽

Haitao Sui

Keyword(s):

Blood Loss ◽

Internal Fixation ◽

Fracture Healing ◽

Clinical Symptoms ◽

Operation Time ◽

Healing Time ◽

Fixation Methods ◽

Plate Group ◽

Clavicle Fractures

SUMMARY OBJECTIVE To compare the effect of two internal fixation methods in the treatment of proximal clavicle fractures. METHODS Fifty patients with proximal clavicle fractures received surgical treatment. They were divided into a clavicular T-plate group and a double mini-plates group. The duration of the operation, blood loss during the operation, fracture healing time, and incision infection were evaluated between the two groups. RESULTS Operation time (t=2.063, P=0.058), intraoperative bleeding (t=1.979, P=0.062), and fracture healing time (t=1.082, P=0.066) were not statistically significant in the two groups. The patients were followed up for 12-18 months; one patient in the T-plate group had early removal of nails, but no clinical symptoms. At the 2-month follow-up, the ASES score in the double mini-plates group was significantly better than in the T-plate group (P<0.001); but at the 6-month follow-up, 1-week before removal of internal fixation and the final follow-up, the two groups had no significant differences (P>0.05). CONCLUSIONS Both internal fixations have similar clinical results in the duration of operation, blood loss during the operation, and fracture healing time. The double mini-plates fixation presents advantages by reducing complications and speeding fracture healing; thus it is a more effective method to treat proximal clavicle fractures.

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