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Comparison of the efficacy of a distal clavicular locking plate versus a clavicular hook plate in the treatment of unstable distal clavicle fractures and a systematic literature review

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Abstract

Purpose

The purpose of this study was to retrospectively compare and review the clinical outcomes between the distal clavicular locking plate and clavicular hook plates in the treatment of unstable distal clavicle fractures; moreover, the relevant literature of the two fixation methods was reviewed systematically to identify the non-union, complications, or functional scores, according to the treatment methods and determine which treatment method is better.

Methods

Sixty-six patients with 66 unstable distal clavicle fractures who underwent open reduction and internal fixation with either a distal clavicular locking plate (36 patients) or a clavicular hook plate (30 patients ) were evaluated. The main outcome comparisons included Constant score, rate of non-union, rate of complication, and rate of returning to work three months postoperatively.

Results

No significant difference was found between locking plate and hook plate groups in union rate and Constant score (P > 0.05). However, the results indicated that the distal clavicular locking plate group had a significantly lower rate of complications (P < 0.05) and symptomatic hardware (P < 0.05). In addition, the distal clavicular locking plate facilitated the return to work better than the clavicular hook plate (P < 0.05).

Conclusions

Both distal clavicular locking plate and clavicular hook plate achieved good results in the treatment of unstable distal clavicle fractures; however, internal fixation with a distal clavicular locking plate had greater ability to return to their previous work after surgery in three months and fewer complications than the clavicular hook plate.

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References

  1. Edwards DJ, Kavanagh TG, Flannery MC (1992) Fractures of the distal clavicle: a case for fixation. Injury 23:44–46

    Article  CAS  PubMed  Google Scholar 

  2. Van der Meijden OA, Gaskill TR, Millett PJ (2012) Treatment of clavicle fractures: current concepts review. J Should Elb Surg 21:423–429

    Article  Google Scholar 

  3. Kao FC, Chao EK, Chen CH et al (2001) Treatment of distal clavicle fracture using Kirschner wires and tension-band wires. J Trauma 51:522–525

    Article  CAS  PubMed  Google Scholar 

  4. Macheras G, Kateros KT, Savvidou OD et al (2005) Coracoclavicular screw fixation for unstable distal clavicle fractures. Orthopedics 28:693–696

    PubMed  Google Scholar 

  5. Chen CH, Chen WJ, Shih CH (2002) Surgical treatment for distal clavicle fracture with coracoclavicular ligament disruption. J Trauma 52:72–78

    Article  PubMed  Google Scholar 

  6. Muramatsu K, Shigetomi M, Matsunaga T et al (2007) Use of the AO hook-plate for treatment of unstable fractures of the distal clavicle. Arch Orthop Trauma Surg 127:191–194

    Article  CAS  PubMed  Google Scholar 

  7. Tambe AD, Motkur P, Qamar A et al (2006) Fractures of the distal third of the clavicle treated by hook plating. Int Orthop 30:7–10

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Kashii M, Inui H, Yamamoto K (2006) Surgical treatment of distal clavicle fractures using the clavicular hook plate. Clin Orthop Relat Res 447:158–164

    Article  PubMed  Google Scholar 

  9. Renger RJ, Roukema GR, Reurings JC et al (2009) The clavicle hook plate for Neer type II lateral clavicle fractures. J Orthop Trauma 23:570–574

    Article  CAS  PubMed  Google Scholar 

  10. Haidar SG, Krishnan KM, Deshmukh SC (2006) Hook plate fixation for type II fractures of the lateral end of the clavicle. J Shoulder Elbow Surg 15:419–423

    Article  PubMed  Google Scholar 

  11. Tiren D, Van Bemmel AJ, Swank DJ et al (2012) Hook plate fixation of acute displaced lateral clavicle fractures: mid-term results and a brief literature overview. J Orthop Surg Res 7:2. doi:10.1186/1749-799X-7-2

    Article  PubMed  PubMed Central  Google Scholar 

  12. Lee YS, Lau MJ, Tseng YC et al (2009) Comparison of the efficacy of hook plate versus tension band wire in the treatment of unstable fractures of the distal clavicle. Int Orthop 33:1401–1405

    Article  PubMed  PubMed Central  Google Scholar 

  13. Meda PV, Machani B, Sinopidis C et al (2006) Clavicular hook plate for lateral end fractures: a prospective study. Injury 37:277–283

    Article  PubMed  Google Scholar 

  14. Andersen JR, Willis MP, Nelson R et al (2011) Precontoured superior locked plating of distal clavicle fractures: a new strategy. Clin Orthop Relat Res 469:3344–3350

    Article  PubMed  PubMed Central  Google Scholar 

  15. Kalamaras M, Cutbush K, Robinson M (2008) A method for internal fixation of unstable distal clavicle fractures: early observations using a new technique. J Shoulder Elbow Surg 17:60–62

    Article  PubMed  Google Scholar 

  16. Martetschläger F, Kraus TM, Schiele CS et al (2012) Treatment for unstable distal clavicle fractures (Neer 2) with locking T-plate and additional PDS cerclage. Knee Surg Sports Traumatol Arthrosc 21(5):1189–1194

    Article  PubMed  Google Scholar 

  17. Herrmann S, Schmidmaier G, Greiner S (2009) Stabilisation of vertical unstable distal clavicular fractures (Neer 2b) using locking T-plates and suture anchors. Injury 40:236–239

    Article  CAS  PubMed  Google Scholar 

  18. Kaipel M, Majewski M, Regazzoni P (2010) Double-plate fixation in lateral clavicle fractures-a new strategy. J Trauma 69:896–900

    Article  PubMed  Google Scholar 

  19. Schliemann B, Roßlenbroich SB, Schneider KN et al (2013) Surgical treatment of vertically unstable lateral clavicle fractures (Neer 2b) with locked plate fixation and coracoclavicular ligament reconstruction. Arch Orthop Trauma Surg 133:935–939

    Article  PubMed  Google Scholar 

  20. Largo RD, Rudin MA, Hotz TK et al (2011) Anatomic reconstruction of unstable lateral clavicular fractures. J Trauma 71:1348–1351

    Article  PubMed  Google Scholar 

  21. Constant CR, Murley AHG (1987) A clinical method of functional assessment of the shoulder. Clin Orthop 214:160–164

    PubMed  Google Scholar 

  22. Neer CS 2nd (1968) Fractures of the distal third of the clavicle. Clin Orthop Relat Res 58:43–50

    PubMed  Google Scholar 

  23. Kona J, Bosse MJ, Staheli JW et al (1990) Type II distal clavicle fractures: a retrospective review of surgical treatment. J Orthop Trauma 4:115–120

    Article  CAS  PubMed  Google Scholar 

  24. Post M (1989) Current concepts in the treatment of fractures of the clavicle. Clin Orthop 245:89–101

    PubMed  Google Scholar 

  25. Yamaguchi H, Arakawa H, Kobayashi M (1998) Results of the Bosworth method for unstable fractures of the distal clavicle. Int Orthop 22:366–368

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Tan HL, Zhao JK, Qian C et al (2012) Clinical results of treatment using a clavicular hook plate versus a T-plate in neer type II distal clavicle fractures. Orthopedics 35:e1191–e1197

    Article  PubMed  Google Scholar 

  27. ElMaraghy AW, Devereaux MW, Ravichandiran K et al (2010) Subacromial morphometric assessment of the clavicle hook plate. Injury 41:613–619

    Article  PubMed  Google Scholar 

  28. Mizue F, Shirai Y, Ito H (2000) Surgical treatment of comminuted fractures of the distal clavicle using Wolter clavicular plates. J Nippon Med Sch 67:32–34

    Article  CAS  PubMed  Google Scholar 

  29. Klein SM, Badman BL, Keating CJ et al (2010) Results of surgical treatment for unstable distal clavicular fractures. J Shoulder Elbow Surg 19:1049–1055

    Article  PubMed  Google Scholar 

  30. Yu C, Sun YH, Zhao CQ et al (2009) Treatment of distal clavicle fracture with distal radius volar locking compression plate. Chin J Traumatol 12:299–301

    PubMed  Google Scholar 

  31. Lu C, Kao F, Hsu K et al (2011) Evaluation of a clavicle hook plate for fixation of unstable distal end comminuted clavicle fractures: seven case reports. Formos J Musculoskelet Disord 2:102–105

    Article  Google Scholar 

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Conflict of interest statement

None declared.

IRB approval/research ethics committee, or local equivalent state

This study was approved by the Ethics Committee of our institutes. Informed consent was obtained from all patients.

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Correspondence to Chunlin Zhang or Junwu Huang.

Additional information

Chunlin Zhang, Junwu Huang and Yi Luo are all co-first authors.

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Zhang, C., Huang, J., Luo, Y. et al. Comparison of the efficacy of a distal clavicular locking plate versus a clavicular hook plate in the treatment of unstable distal clavicle fractures and a systematic literature review. International Orthopaedics (SICOT) 38, 1461–1468 (2014). https://doi.org/10.1007/s00264-014-2340-z

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  • DOI: https://doi.org/10.1007/s00264-014-2340-z

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