Advertisement

International Orthopaedics

, Volume 30, Issue 1, pp 7–10 | Cite as

Fractures of the distal third of the clavicle treated by hook plating

  • A.D. TambeEmail author
  • P. Motkur
  • A. Qamar
  • S. Drew
  • S.M. Turner
Original Paper

Abstract

We retrospectively assessed the union and shoulder function following hook plate fixation in 18 patients with Neer type 2 fractures of the lateral end of the clavicle. The average age was 40 (range 22–62) years, and the mean follow-up was 25 (range 6–48) months. Fifteen patients had acute fractures and the rest were non-unions. Complications included two non-unions, one following a deep infection. There were no iatrogenic fractures. Acromial osteolysis was seen in five patients who had their plates in situ. The average pain score at rest was 1 (range 0–4), and the average pain score on abduction was 2.2 (range 0–5). The average Constant score was 88.5 (range 63–100). Patients were asked to rate their shoulder function; three rated it as normal, 11 as nearly normal and one as not normal. Hook plate fixation appears to be a valuable method of stabilising Neer type 2 fractures of the clavicle, resulting in high union rates and good shoulder function. These plates need to be removed after union to prevent acromial osteolysis.

Keywords

Constant Score Shoulder Function Unstable Fracture Hook Plate Clavicular Fracture 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Résumé

Nous avons étudié rétrospectivement, chez 18 malades, la consolidation des fractures du quart externe de la clavicule type 2 de Neer et la fonction de l'épaule, après fixation par plaque crochet. L'âge moyen était de 40 (20–62) ans et la moyenne de suivi de 25 (6–48) mois. Quinze avaient une fracture fraîche les autres une pseudarthrose. Les complications ont inclus deux non consolidations, dont l'une après une infection profonde. Il n'y avait pas de fracture iatrogénique. Une ostéolyse acromiale a été noté chez cinq malades qui avaient la plaque en place. Le score moyen de la douleur au repos était de 1 (0–4) et celui en abduction était de 2,2 (0–5). Le score moyen de Constant était de 88,5 (63–100). On a demandé aux patients d'estimer la fonction de leur épaule; trois ont dit que leur épaule était normale, onze ont dit qu'elle était presque normale et un a estimé quelle n'était pas normale. La fixation par plaque crochet paraît être une bonne méthode pour stabiliser les fractures de type Neer 2 de la clavicule, permettant un taux élevé de consolidation et une bonne fonction de l'épaule. Ces plaques ont besoin d'être enlevé après la consolidation pour prévenir l'ostéolyse de l'acromion.

References

  1. 1.
    Ballmer FT, Gerber C (1991) Coracoclavicular screw fixation for unstable fractures of the distal clavicle. A report of five cases. J Bone Joint Surg Br 73:291–294PubMedGoogle Scholar
  2. 2.
    Edwards DJ, Kavanagh TG, Flannery MC (1992) Fractures of the distal clavicle: a case for fixation. Injury 23:44–46CrossRefPubMedGoogle Scholar
  3. 3.
    Eskola A, Vainionpaa S, Patiala H et al (1987) Outcome of operative treatment in the in fresh lateral clavicular fractures. Ann Chir Gynaecol Fenn 76:167–169Google Scholar
  4. 4.
    Fann CY, Chiu FY, Chuang TY, Chen CM, Chen TH (2004) Transacromial Knowles pins in the treatment of Neer type 2 displaced clavicle fractures. A prospective evaluation of 32 cases. J Trauma 56:1102–1106PubMedGoogle Scholar
  5. 5.
    Faraj AA, Ketzer B (2001) The use of hook plate in the management of acromioclavicular injuries. Report of ten cases. Acta Orthop Belg 67:448–451PubMedGoogle Scholar
  6. 6.
    Flinkkila T, Ristiniemi J, Hyvonen P, Hamalainen M (2002) Surgical treatment of unstable fractures of the distal clavicle: a comparative study of Kirschner wire and clavicular Hook plate fixation. Acta Orthop Scand 73:50–53CrossRefPubMedGoogle Scholar
  7. 7.
    Kona J, Bosse MJ, Staheli JW et al (1990) Type 2 distal clavicle fractures: a retrospective review of surgical treatment. J Orthop Trauma 4:115–120PubMedCrossRefGoogle Scholar
  8. 8.
    Neer CS II (1984) Fracture dislocation of the shoulder. In: Rockwood CA Jr, Green DP (eds) Fractures in adults, 2nd edn. Lippincott, Philadelphia, pp 711–712Google Scholar
  9. 9.
    Neer CS (1963) Fractures of the distal third of the clavicle with detachment of the coracoclavicular ligament in adults. J Trauma 3:99–100PubMedCrossRefGoogle Scholar
  10. 10.
    Neviaser RJ (1987) Injuries of the clavicle and the acromioclavicular joint. Orthop Clin North Am 18:433–438PubMedGoogle Scholar
  11. 11.
    Nordqvist A, Petersson C, Redulund-Johnell I (1993) The natural course of lateral clavicular fractures. 15 (11–21) year follow up of 110 cases. Acta Orthop Scand 64:87–91PubMedGoogle Scholar
  12. 12.
    Prost M (1978) The shoulder, surgical and non-surgical management. Lea & Febiger, PhiladelphiaGoogle Scholar
  13. 13.
    Yamaguchi H, Arakawa H, Kobayashi M (1998) Results of the Bosworth method for unstable fractures of the distal clavicle. Int Orthop 22:366–368CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • A.D. Tambe
    • 1
    • 3
    Email author
  • P. Motkur
    • 2
  • A. Qamar
    • 1
  • S. Drew
    • 2
  • S.M. Turner
    • 2
  1. 1.Royal Orthopaedic HospitalBirminghamUK
  2. 2.University Hospitals of Coventry & Warwickshire NHS TrustConventryUK
  3. 3.YorkUK

Personalised recommendations