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.

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.

scholarly journals Reduction of subacromial osteolysis by bending the hook arthroscopically in clavicle hook plate fixation for distal clavicle fractures

2020 ◽  
Author(s):  
Atsushi Okazaki ◽  
Hiroaki Sakano ◽  
Tsuyoshi Takeuchi ◽  
Yutaka Inaba
Keyword(s):  
Rotator Cuff ◽  
Plate Fixation ◽  
Distal Portion ◽  
Rotator Cuff Tears ◽  
Bony Defect ◽  
Distal Clavicle ◽  
Plate Removal ◽  
Clavicle Fractures ◽  
Distal Clavicle Fractures ◽  
Clavicle Hook Plate

Abstract Background: Subacromial osteolysis is a serious complication caused by clavicle hook plates. Incongruency between the hook and undersurface of the acromion has been reported as a cause of subacromial osteolysis. The aim of this study was to retrospectively examine the effectiveness of hook bending in reducing subacromial osteolysis. Methods: Twenty-two patients with unstable distal clavicle fractures were treated with clavicle hook plates. There were 19 males and 3 females, with a mean age of 55.0 years. They were followed for a mean period of 9.5 months. The patients were divided into two groups; there were 10 patients whose hook was bent (the bending group) and 12 patients whose hook was not bent (the nonbending group). In the bending group, the hook was bent using a dedicated bender such that the hook and the undersurface of the acromion were parallel, and the direction of the hook was confirmed arthroscopically. At plate removal, arthroscopy was performed in both groups to observe the subacromial bony defect and the rotator cuff injury. Results: One patient in the nonbending group had a fibrous union, but bone union was achieved in all other patients. In the bending group, the angle at which the hook was inclined downward with respect to the distal portion of the plate (hook inclination angle) was 9.3 ± 6.1˚ (range, 2-23˚). The subacromial bony defects were significantly smaller in the bending group (1.7 ± 2.4 mm) than in the nonbending group (4.7 ± 2.3 mm) (P<0.05). Partial-thickness rotator cuff tears localized around the hook were observed arthroscopically in 6 patients in the bending group (60%) and in 7 patients in the nonbending group (58%). Conclusions: When the hook was bent such that it was parallel to the undersurface of the acromion, the degree of subacromial osteolysis was reduced.

Analysis of Treatment Results of Unstable Distal Clavicle Fractures Using Hook Plate

2014 ◽  
Vol 49 (5) ◽  
pp. 374 ◽  
Author(s):  
Ho-Seung Jeon ◽  
Young-Kyun Woo ◽  
Seok-Ha Hwang ◽  
Seung-Pyo Suh ◽  
Seo-Goo Kang ◽  
...  
Keyword(s):  
Hook Plate ◽  
Distal Clavicle ◽  
Treatment Results ◽  
Clavicle Fractures ◽  
Distal Clavicle Fractures

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 fracture of Neer type II with locking plate in combination with titanium cable under the guide

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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