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 Treatment of Distal Clavicle Fractures using a Scorpion Plate and Influence of Timing on Surgical Outcomes: A Retrospective Cohort Study of 105 Cases

2019 ◽  
Author(s):  
Ryogo Furuhata ◽  
Masaaki Takahashi ◽  
Teppei Hayashi ◽  
Miyu Inagawa ◽  
Aki Kono ◽  
...  
Keyword(s):  
Treatment Group ◽  
Postoperative Complications ◽  
Surgical Outcomes ◽  
Plate Fixation ◽  
Delayed Union ◽  
Distal Clavicle ◽  
Delayed Treatment ◽  
Clavicle Fractures ◽  
The Difference ◽  
Distal Clavicle Fractures

Abstract Background Plate fixation is the established method of treating unstable distal clavicle fractures. However, the appropriate timing of surgery for acute distal clavicle fractures remains unclear. The present study aimed to evaluate the clinical outcomes of osteosynthesis using a Scorpion plate and to assess the influence of surgery timing on the surgical outcomes for acute unstable distal clavicle fractures. Methods We retrospectively reviewed 105 patients who underwent fixation for acute unstable distal clavicle fractures (Neer type II and V) using the Scorpion plate between 2008 and 2018. Patients were divided into early (45 patients) and delayed (60 patients) treatment groups based on the timing of the surgical intervention (within or after seven days). The outcomes were postoperative complications (delayed union, peri-implant fracture, plate loosening, plate-related pain, and stiffness). We evaluated the outcomes from X-ray radiographs and clinical notes.Results Among the 105 patients, delayed union, plate loosening, plate-related pain, and stiffness were observed in six patients (5.7%), four patients (3.8%), seven patients (6.7%), and one (1.0%) patient, respectively. The delayed union rate was significantly higher in the delayed treatment group than that in the early treatment group (P=0.036). Although the difference was not significant, plate loosening and stiffness were only observed in the delayed treatment group. Conclusion Our results demonstrated that osteosynthesis using Scorpion plates achieved satisfactory surgical outcomes for unstable distal clavicle fractures . In addition, this study suggested that performing surgery within six days after injury is recommended to reduce postoperative complications .

scholarly journals Treatment of Distal Clavicle Fractures using a Scorpion Plate and Influence of Timing on Surgical Outcomes: A Retrospective Cohort Study of 105 Cases

2020 ◽  
Author(s):  
Ryogo Furuhata ◽  
Masaaki Takahashi ◽  
Teppei Hayashi ◽  
Miyu Inagawa ◽  
Aki Kono ◽  
...  
Keyword(s):  
Treatment Group ◽  
Postoperative Complications ◽  
Surgical Outcomes ◽  
Plate Fixation ◽  
Distal Clavicle ◽  
Delayed Treatment ◽  
Surgery Timing ◽  
Clavicle Fractures ◽  
The Difference ◽  
Distal Clavicle Fractures

Abstract Background Plate fixation is an established method for treating unstable distal clavicle fractures. However, the appropriate timing of surgery for acute distal clavicle fractures remains unclear. The present study aimed to evaluate the clinical outcomes of osteosynthesis using a Scorpion plate and to assess the influence of surgery timing on the surgical outcomes for acute unstable distal clavicle fractures. Methods We retrospectively reviewed 105 patients who underwent fixation for acute unstable distal clavicle fractures (Neer type II and V) using the Scorpion plate between 2008 and 2018. Patients were divided into early (45 patients) and delayed (60 patients) treatment groups based on the timing of the surgical intervention (within or after seven days). The outcomes were postoperative complications (nonunion, peri-implant fracture, plate loosening, plate-related pain, and stiffness). We evaluated the outcomes from X-ray radiographs and clinical notes. Results Among the 105 patients, nonunion, plate loosening, plate-related pain, and stiffness were observed in six patients (5.7%), four patients (3.8%), seven patients (6.7%), and one patient (1.0%), respectively. The nonunion rate was significantly higher in the delayed treatment group than that in the early treatment group (P=0.036). Although the difference was not significant, plate loosening and stiffness were only observed in the delayed treatment group. Conclusion Our results demonstrated that osteosynthesis using Scorpion plates achieved satisfactory surgical outcomes for unstable distal clavicle fractures . In addition, this study suggested that performing surgery within six days after injury is recommended to reduce postoperative complications .

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.

scholarly journals Persistent pain of distal clavicle fractures with a large lateral angle acromion treated with a clavicle hook plate: Report on 9 cases

2019 ◽  
Author(s):  
Kailun Wu ◽  
Hao Xu ◽  
Yingjie Xu ◽  
Huilin Yang ◽  
Jiong Jiong Guo
Keyword(s):  
Rotator Cuff ◽  
Hook Plate ◽  
Distal Clavicle ◽  
Mri Findings ◽  
Level Of Evidence ◽  
Lateral Angle ◽  
Clavicle Fractures ◽  
Clinical Records ◽  
Distal Clavicle Fractures ◽  
Clavicle Hook Plate

Abstract Background: The clavicular hook plate was a popular surgical treatment for distal clavicle fractures. The relationship among characteristics of the hook plate, acromioclavicular joint morphology and clinical outcome has remained poorly understood. We reviewed the clinical records of patients who had distal clavicle fractures with large lateral angle of acromion treated using a clavicle hook plate and evaluated the feasibility of this technique.Methods: Between 2010 and 2017, 9 patients (4 male and 5 female; mean age, 43 years) who had distal clavicle fractures with a large lateral angle of acromion were treated by clavicle hook plate at our institute. Follow-up ranged from 18 to 28 months (mean, 23 months). We examined clinical characteristics, MRI findings, treatments, and outcomes.Results: All patients complained of implant-related symptoms postoperatively. Clinical subacromial impingement was observed in all of them. Two patients had relief after removing the device. The symptoms in the remaining seven patients did not subside after removal of plate. Rotator cuff lesions were found in these cases, five of whom received rotator cuff repair and achieved remission of their symptoms.Conclusion: Distal clavicle–acromion coronal angle is an important factor for postoperative efficacy of the hook plate. The selection of a hook plate that makes the contact position between the hook and acromion more proximal may be helpful. Early limited mobility and removal of the implant may improve the prognosis and reduce the rate of impingement and rotator cuff lesions.Study Design: Restropective Review, Level of evidence, 4.

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