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International Orthopaedics

, Volume 33, Issue 5, pp 1401–1405 | Cite as

Comparison of the efficacy of hook plate versus tension band wire in the treatment of unstable fractures of the distal clavicle

  • Yih-Shiunn Lee
  • Ming-Jye Lau
  • Ya-Chun Tseng
  • Wen-Chiao Chen
  • Hsin-Yi Kao
  • Jyh-Ding WeiEmail author
Original Paper

Abstract

Fifty-two patients with unstable fractures of distal clavicle treated by open reduction and internal fixation with hook plates or tension band wires were retrospectively reviewed. The 52 patients were divided into two groups based on the method of treatment. The hook plate (HP) group included 32 patients and the tension band wire (TBW) group included 20 patients. Both groups were similar in respect to injury mechanisms, compounding medical conditions, and shoulder score (p > 0.1). However, hook plating had a significantly lower rate of complication (p = 0.01) and symptomatic hardware (p = 0.001). In addition, hook plating better facilitated the return to work and athletic activity (p = 0.004 and p = 0.003, respectively). In conclusion, if surgery of distal clavicular fractures is indicated, internal fixation with a hook plate has more advantages than with tension band wires.

Keywords

Unstable Fracture Athletic Activity Hook Plate Subacromial Impingement Distal Clavicle 
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

52 patients présentant une fracture instable de la clavicule ont été traités par réduction sanglante et fixation interne par plaques crochet. Les 52 patients ont été revus et ont été divisés en deux groupes en fonction de la méthode de traitement. L’ostéosynthèse par plaques crochet HP groupe 1 incluait 32 patients et le haubannage TBW 20 patients. Les deux groupes sont identiques en ce qui concerne le mécanisme des traumatismes, les problèmes médicaux, les scores épaule (p > 0,1). Cependant le traitement par crochet-plaque permet une diminution significative des complications (p = 0,01) notamment matérielles (p = 0,001). Par ailleurs cette ostéosynthèse par crochet-plaque permet une reprise plus rapide du travail et des activités sportives (p = 0,004, 0,003 respectivement). En conclusion, si il existe une indication chirurgicale dans les fractures distales de la clavicule, il est indiqué de réaliser l’ostéosynthèse par crochet-plaque. Cette ostéosynthèse présente beaucoup plus d’avantages que l’ostéosynthèse par hauban.

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(2):291–294PubMedGoogle Scholar
  2. 2.
    Constant CR, Murley AHG (1987) A clinical method of functional assessment of the shoulder. Clin Orthop 214:160–164PubMedGoogle Scholar
  3. 3.
    Edwards DJ, Kavanagh TG, Flannery MC (1992) Fractures of the distal clavicle: a case for fixation. Injury 23(1):44–46PubMedCrossRefGoogle Scholar
  4. 4.
    Eskola A, Vainonpaa S, Patiala H et al (1987) Outcome of operative treatment in fresh lateral clavicular fracture. Ann Chir Gynaecol 76(3):167–169PubMedGoogle Scholar
  5. 5.
    Flinkkilä T, Ristiniemi J, Hyvönen P et al (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(1):50–53PubMedCrossRefGoogle Scholar
  6. 6.
    Kashii M, Inui H, Yamamoto K (2006) Surgical treatment of distal clavicle fractures using the clavicular hook plate. Clin Orthop 447:158–164PubMedCrossRefGoogle Scholar
  7. 7.
    Kiefer H, Claes I, Burri C et al (1986) The stabilizing effect of various implants on the torn acromioclavicular joint. A biomechanical study. Arch Orthop Trauma Surg 106(1):42–46PubMedCrossRefGoogle Scholar
  8. 8.
    Kona J, Bosse MJ, Staheli JW et al (1990) Type II distal clavicle fractures: a retrospective review of surgical treatment. J Orthop Trauma 4(2):115–120PubMedGoogle Scholar
  9. 9.
    Leppilahti J, Jalovaara P (1999) Migration of Kirschner wires following fixation of the clavicle – a report of 2 cases. Acta Orthop Scand 70(5):517–519PubMedGoogle Scholar
  10. 10.
    Mizue F, Shirai Y, Ito H (2000) Surgical treatment of comminuted fractures of the distal clavicle using Wolter clavicular plate. J Nippon Med Sch 67(1):32–34PubMedCrossRefGoogle Scholar
  11. 11.
    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(3):191–194PubMedCrossRefGoogle Scholar
  12. 12.
    Neer CS (1963) Fracture of the distal clavicle with detachment of the coracoclavicular ligaments in adults. J Trauma 3:99–110PubMedCrossRefGoogle Scholar
  13. 13.
    Neer CS (1968) Fractures of the distal third of the clavicle. Clin Orthop 58:43–50PubMedGoogle Scholar
  14. 14.
    Nordqvist A, Petersson C, Redlund-Johnell I (1993) The natural course of lateral clavicle fracture. 15 (11–21) year follow-up of 110 cases. Acta Orthop Scand 64(1):87–91PubMedCrossRefGoogle Scholar
  15. 15.
    Post M (1989) Current concepts in the treatment of fractures of the clavicle. Clin Orthop 245:89–101PubMedGoogle Scholar
  16. 16.
    Tambe AD, Motkur P, Qamar A et al (2006) Fractures of the distal third of the clavicle treated by hook plating. Int Orthop 30(1):7–10PubMedCrossRefGoogle Scholar
  17. 17.
    Yamaguchi H, Arakawa H, Kobayashi M (1998) Results of the Bosworth method for unstable fractures of the distal clavicle. Int Orthop 22(6):366–368PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Yih-Shiunn Lee
    • 1
  • Ming-Jye Lau
    • 1
  • Ya-Chun Tseng
    • 2
  • Wen-Chiao Chen
    • 1
  • Hsin-Yi Kao
    • 3
  • Jyh-Ding Wei
    • 4
    Email author
  1. 1.Department of Orthopedic SurgeryLin Shin HospitalTaichung CityTaiwan
  2. 2.Department of PediatricsLin Shin HospitalTaichung CityTaiwan
  3. 3.Department of NursingLin Shin HospitalTaichung CityTaiwan
  4. 4.Department of Orthopedic SurgeryShin-Kong Wu Ho-Su Memorial HospitalTaipeiTaiwan

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