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Background
This study aimed to compare the clinical and radiological outcomes of distal clavicle fracture fixation with a hook plate versus the standard non-locking T-plate for unstable Neer type II fractures.
Methods
A prospective matched cohort study including two groups of hook plates and T-plates fixation was conducted in our two tertiary trau...
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Background
Fractures of the clavicle are common injuries, which often require reduction and internal fixation. Although Kirschner pins have been commonly used to treat these fractures with good results, migration of these devices may result in severe internal lesions.
Case presentation
We report herein the case of 61-year-old man, who presented fo...
Citations
... These perfect outcomes were also repeated in studies with T plate fixation augmented with CC reconstruction techniques in Neer 2b distal clavicular fractures (18,(23)(24)(25). The superiority of this plate to the clavicular hook plate is also noted in literature (26,27). ...
Background: The purpose of the current study was to compare the clinical and radiographic outcomes of distal radius volar T plate and pre-contoured locking plate in distal clavicle fracture. Methods: A total of 60 patients with Neer 2b distal clavicle fracture were included in this study and underwent open reduction and internal fixation (ORIF) between March 2019 and November 2020 via two different plates, distal radius volar T plate and distal clavicle pre-contoured locking plate. All patients were followed at least two years post-operative. Union rate, time to union, need to device removal, and Constant-Murley score (CMS) were assessed among them. Results: In all patients, the bony union was achieved without wound-related complications. The mean time to union in distal radius volar T plate group was 3.3 ± 0.6 months and in the pre-contoured locking plate group was 3.6 ± 0.7 (P = 0.14). The mean CMS was 93.1 ± 2.2 and 92.1 ± 2.5 in T plate group and pre-contoured plate group, respectively (P = 0.09). Five cases with T plate and eight cases with pre-contoured plate were candidates for device removal (P = 0.53). Conclusion: Distal radius volar T plate could be a reasonable choice to manage Neer 2b distal clavicle fracture as it restores functional range of motion (ROM) with excellent bone union and without the necessity of device removal, besides its economical price.
... Although patients with complications had lower patient-reported outcome scores compared to patients without complications, there were no statistically significant differences in mean SSV (80.9% [range, 20- [19]. In a study by Li et al., no revision was necessary in any of the 81 patients followed up [20]. ...
Background
Surgical treatment of distal clavicle fractures Neer type II is challenging. A gold standard has not yet been established, thus various surgical procedures have been described. The purpose of this study is to report the radiological and clinical outcomes using hook plate fixation in Neer type II distal clavicle fractures.
Methods
We retrospectively reviewed data of 53 patients who underwent hook plate fixation between December 2009 and December 2019 with ≥ 2 years of follow-up. Patients with preexisting pathologies or concomitant injuries of the ipsilateral shoulder were excluded. Pre- and postoperative coracoclavicular distance (CCD), bony union and patient-reported outcomes were collected, including the Constant Score (CS) and Subjective Shoulder Value (SSV). Complications and revisions were recorded.
Results
At a mean final follow-up of 6.2 years, mean SSV was 91.0% (range, 20–100) and mean CS was 80.9 points (range, 25–99). The mean preoperative CCD was 19.0 mm (range, 5.7–31.8), the mean postoperative CCD was 8.2 mm (range, 4.4–12.2) and the mean CCD following hardware removal was 9.7 mm (range, 4.7–18.8). The loss of reduction following hardware removal was statistically significant (P = 0.007). Eleven (20.8%) patients had complications, with 5 cases of deep or superficial infection (9.4%), four non-unions (7.5%), one periosteosynthetic fracture, one postoperative seroma, one implant failure and one symptomatic acromioclavicular joint arthritis (all 1.9%). A total of 10 patients (18.9%) underwent revision surgery at a mean of 113 (range, 7–631) days.
Conclusion
Medium-term patient-reported outcomes for hook plate fixation of Neer type II distal clavicle fractures are satisfactory; however, one in five patients suffers a complication with the majority of them requiring revision surgery.
... patients had complications. The most common complication was deep or super cial infection ( Here, a revision rate of 6.7% is reported in the hook plate group [19]. In a study by Li et al., no revision was necessary in any of the 81 patients followed up [20]. ...
Background: Surgical treatment of distal clavicle fractures Neer type II is challenging. A gold standard has not yet been established, thus various surgical procedures have been described. The purpose of this study is to report the radiological and clinical outcomes using hook plate fixation in Neer type II distal clavicle fractures.
Methods: We retrospectively reviewed data of 53 patients who underwent hook plate fixation between December 2009 and December 2019 with ≥2 years of follow-up. Patients with preexisting pathologies or concomitant injuries of the ipsilateral shoulder were excluded. Pre- and postoperative coracoclavicular distance (CCD), bony union and patient-reported outcomes were collected, including the Constant Score (CS) and Subjective Shoulder Value (SSV). Complications and revisions were recorded.
Results: At a mean final follow-up of 6.2 years, mean SSV was 91.0% (range, 20 – 100) and mean CS was 80.9 points (range, 25 – 99). The mean preoperative CCD was 19.0mm (range, 5.7 – 31.8), the mean postoperative CCD was 8.2mm (range, 4.4 – 12.2) and the mean CCD following hardware removal was 9.7mm (range, 4.7 – 18.8). The loss of reduction following hardware removal was statistically significant (P = 0.007). Eleven (20.8%) patients had complications, with 5 cases of deep or superficial infection (9.4%), four non-unions (7.5%), one periosteosynthetic fracture, one postoperative seroma, one implant failure and one symptomatic acromioclavicular joint arthritis (all 1.9%). A total of 10 patients (18.9%) underwent revision surgery at a mean of 113 (range, 7 – 631) days.
Conclusion: Medium-term patient-reported outcomes for hook plate fixation of Neer type II distal clavicle fractures are satisfactory; however, one in five patients suffers a complication with the majority of them requiring revision surgery.
... Osteosinteza preloma Neer IIB tipa anatomskom pločom i zavrtnjima pokazala je dobre rezultate [21]. Pokazano je da se njome postiže dobra stabilnost na mestu preloma, a sama intraoperativna manipulacija implantatom je jednostavna [18,22]. ...
... Osteosynthesis of a Neer type IIB fracture with an anatomical plate and screws has shown good results [21]. It has been shown that good stability at the site of the fracture is achieved with this technique, while intraoperative manipulation of the implant is simple [18,22]. ...
Introduction: Fractures of the distal end of the clavicle account for 10% - 30% of all fractures of this bone, however, they account for as many as 50% of nonunions and malunions in clavicle fractures. Of all distal clavicle fractures, the highest percentage of complications appertain to Neer type IIB fractures. The aim of this paper is to describe the case of a female patient with a Neer type IIB clavicle fracture treated by fracture reduction and flexible stabilization of the coracoclavicular joint using the TightRope system. Case report: A 48-year-old female patient, injured in a traffic accident while driving a car, suffered a Neer type IIB fracture of the distal edge of the left clavicle. Three days after the injury, the patient underwent indirect stabilization surgery of the coracoclavicular joint by fixation, with the application of the TightRope system. Rehabilitation began on the first postoperative day and was completed three months after surgery, with the achievement of full range of motion in the left shoulder, return of muscle tone and strength of the shoulder muscles, followed by a return to everyday life and work activities, as before the injury. Conclusion: Although no gold standard exists in the operative treatment of the above-described injuries, the indirect method of stabilization and flexible fixation of the coracoclavicular joint, using different types of sutures, achieves good to excellent results. Comparing this method with other described techniques indicates that it has a better functional result, which is achieved faster with a lower complication rate. Our patient's functional results contribute to literature data and yet again demonstrate the effectiveness of this type of treatment for these complex injuries.
Clavicle fractures are among the most prevalent types of fractures with numerous treatment strategies that have evolved over time. In the realm of lateral-third cla-vicle fracture management, several surgical methods are available, with plate and screw constructs being one of the most frequently employed options. Within this construct, numerous choices exist for fixing the fracture. This editorial provides an overview of the common plate options utilized in the management of distal third clavicle fractures underscoring the critical considerations and approaches that guide clinicians in selecting the most appropriate fixation techniques, considering the complex landscape of clavicle fractures and their challenging management.
