Periprosthetic Fracture after Hook Plate Fixation in Neer Type II Distal Clavicle Fracture: A Report of 3 Cases

2016 ◽  
Vol 29 (1) ◽  
pp. 55 ◽  
Author(s):  
Kyung Yong Kim ◽  
Joon Yub Kim ◽  
Won Bok Lee ◽  
Myong Gon Jung ◽  
Jeong Hyun Yoo ◽  
...  
2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jun Wang ◽  
Jie Guan ◽  
Minbo Liu ◽  
Yongfeng Cui ◽  
Yuhang Zhang

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.


2009 ◽  
Vol 12 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Jae-Kwang Yum ◽  
Sang-Lim Lee ◽  
Ho-Jong Ra

2018 ◽  
Vol 21 (2) ◽  
pp. 95-100
Author(s):  
Joo Han Oh ◽  
Seunggi Min ◽  
Jae Wook Jung ◽  
Hee June Kim ◽  
Jae Yoon Kim ◽  
...  

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.


2020 ◽  
Vol 8 (5_suppl5) ◽  
pp. 2325967120S0006
Author(s):  
S Zufahrizzat ◽  
AS Nadzim ◽  
O Saifudin ◽  
Rauf A Abdul

Clavicle fracture is a common injury, and can be classified into middle third, medial third, and distal third fractures. Only 10-15% of clavicle fracture occur in the distal third segment. Neer classified the distal clavicle fracture into five types ; type II and V are unstable and requiring fixation . Various common methods of stabilizations are introduced such as K-wiring , tension band fixation , plate fixation, osteosynthesis with hook plate and coracoclavicular screw however all those operative methods have their own advantages and disadvantages. Materials and Methods: We presented a case of 21 years old male with left shoulder pain after motor vehicle accident. Examination revealed tenderness on his left shoulder, and radiograph showed fracture of distal end left clavicle Neer type II, requiring fixation. He was counselled for lateral extension clavicle locking plate but unable to pay due to financial constraint. Results: The patient underwent open reduction and internal fixation using Kirschner wire with tension band fixation . The fracture site was visualized and the hematoma was curetted and washed. The fracture was reduced and fixed with two 1.4 mm trans-acromial Krischner wires and the reduction was checked with an image intensifier. Then the TBW is applied using stainless steel wire size 1.0 . The K-wires are bent beneath the skin. Sling immobilization is used for 2 weeks after the operation. Unrestricted tolerable shoulder motion is permitted. Stretched and exertional exercise is allowed after radiography shows osseous union and the implants are removed. Discussions: TBW is widely employed to treat limb fractures, such as patella and olecranon fracture but seldom used for distal clavicle nowadays. The advantages of TBW are higher antirotation and antibending force compared with that in K-wire fixation and lower profile compared with the bone plate, which reduces tendon irritation and prominent implant. The use of K-wires and TBW also required only the exposure of the fracture site. The soft tissue around the clavicle incurred little damage, leading to a lower infection rate. In addition, the use of K-wires and TBWs can provide a more rigid fixation than K-wires only. Rigid fixation with little complication contributes to good results . Conclusion: Surgical management is recommended for unstable distal clavicle fracture. TBW can be preferred because of the simplicity of the procedure, low cost, simple hardware, high union rate and easy availability of the implant.


2011 ◽  
Vol 24 (1) ◽  
pp. 48 ◽  
Author(s):  
Su-Han Ahn ◽  
Hyeong-Jo Yoon ◽  
Kwang-Yeol Kim ◽  
Hyung-Chun Kim ◽  
In-Yeol Kim

2017 ◽  
Vol 20 (4) ◽  
pp. 230-235
Author(s):  
Woo Dong Nam ◽  
Sung Hoon Moon ◽  
Ki Yong Choi

BACKGROUND: Neer type II distal clavicle fractures have the drawback of coracoclavicular instability and insufficient distal bony fragment, thereby making it difficult to achieve adequate fixation. Although various surgical treatments have been described for Neer type II fracture, the optimal treatment remains controversial. This study reports the clinical results and usefulness of anatomical locking plate with additional K-wire fixation.METHODS: A totally of 21 patients with type II distal clavicle fracture were included in the study. The surgical procedure reduced the fracture temporarily; it included insertion of one or two K-wire from the lateral margin of the distal fragment to the proximal fragment through the fracture site, followed by application and fixation of the locking plate. The bony union and migration of K-wire was evaluated in the follow-up radiography. The coracoclavicular distance and acromioclavicular joint arthrosis were assessed at the final follow-up. The Constant Score (CS) and Korean Shoulder Score (KSS) were evaluated for clinical scoring.RESULTS: Bone union was achieved in all cases. At the final follow-up, coracoclavicular distance of the injured shoulder was increased, as compared to the intact shoulder (p=0.002), with no accompanying clinical symptoms. No K-wire migration was observed. At the final follow-up, K-wire irritation was observed in two cases and acromioclavicular arthrosis in one case, with no other adverse effects. Pain visual analogue scale, CS, and KSS were improved in all cases.CONCLUSIONS: The method of anatomical locking plate with additional K-wire fixation could be useful in achieving beneficial clinical results.


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