Abstract:

BACKGROUND: Kirschner wire tension band or common plate screw fixation is frequently used for distal clavicle fracture. However, tension band wire loosening, screw loosening, plate breakage, pin tract infection, even internal fixation failure frequently occur. Recently, AO clavicle hook-plate has been used to treat distal clavicle fracture and obtained favorable effect. However, it remains controversial whether hook can influence shoulder function.
OBJECTIVE: To observe the outcome of Neer type Ⅱ distal clavicle fracture treated by AO clavicle hook-plate and coracoid-clavicular ligment repair or reconstruction.
METHODS: From September 2002 to March 2008, 27 cases of Neer type Ⅱ unstable fractures of the distal clavicle were treated with AO clavicle hook-plates internal fixation and cocrcoid-clavicular ligment repair or reconstruction. Rehabilitative training began 2 weeks after operation. Plain radiographs of clavicles were used to assess bony union. Functional recovery of the shoulder joint was assessed using the Constant-Murley scoring system.
RESULTS AND CONCLUSION: The 27 patients were followed up for more than 6 months. All fractures eventually achieved solid bony union within 3 months after surgery. The hook plates were removed at an average of 8.2 months after the first operation. Clinical results were satisfied with a mean Constant-Murley score of 87 points. Open reduction and internal fixation with AO clavicle hook-plates is a useful method for unstable fractures of the distal clavicle. The coracoid-clavicular ligment repair or reconstruction must be paid attention while internal fixation was performed.