TightRope system versus clavicular hook plate in the treatment of Neer type II distal clavicle fractures using arthroscopy

doi:10.3969/j.issn.2095-4344.1495

Abstract

Abstract:

BACKGROUND: TightRope device has been widely used for acromioclavicular dislocation. Outside China, a few studies have reported that TightRope device is used for Neer type ll distal clavicle fractures. However, it is less reported in comparison with the traditional treatment of clavicular hook plate.

OBJECTIVE: To observe and compare the clinical results after the arthroscopic treatment using TightRope system and after open repair using clavicular hook plate in Neer type ll distal clavicle fractures.

METHODS: Between October 2015 and February 2018, 26 cases of Neer type ll distal clavicle fractures were admitted to this study in the Affiliated Hospital of Guizhou Medical University. In the TightRope system group, 12 cases underwent arthroscopic treatment using TightRope system. In the clavicular hook plate group, 14 cases underwent open repair using clavicular hook plate. From hospitalization to 1 year after surgery, the perioperative indexes, pain scores, shoulder function scores, radiologic outcomes and complications were collected and compared between the two groups.

RESULTS AND CONCLUSION: The scores of the Oxford Shoulder Score, University of California at Los Angeles, and Constant-Murley Score were better in the TightRope system group than those in the clavicular hook plate group at 6 and 12 months postoperatively (P < 0.05). The range of forward flexion and abduction motion of the shoulder was significantly better in the TightRope system group than in the clavicular hook plate group at 3 and 6 months postoperatively (P < 0.05). One patient in the TightRope system group showed a poor healing of the fracture ends 3 months postoperatively. At 6 months postoperatively, the fracture was healed well. In the clavicular hook plate group, one elderly patient had nonunion; two patients had significant shoulder pain; and one patient had limited shoulder abduction. These complications alleviated gradually after removing the hook plate. These results demonstrated that the arthroscopic treatment using TightRope system is a minimally invasive surgical procedure, and characterized by minor wound, light pain, good functional recovery, and not requiring secondary surgery to remove internal implant, and high patient satisfaction. This study was approved by the Clinical Trial Ethics Committee, the Affiliated Hospital of Guizhou Medical University on May 15, 2019 (approval number: 2019LS226).

Key words: distal clavicle fracture, coracoclavicle ligament, arthroscopy, clavicular hook plate, TightRope, shoulder, acromioclavicular dislocation, minimally invasive surgery, internal fixation, healing

CLC Number:

R459.9|R683|R318

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R459.9|R683|R318

Wu Cheng, Xia Yaqing, Wang Jianji, Liu Riguang, Fan Jiannan. TightRope system versus clavicular hook plate in the treatment of Neer type II distal clavicle fractures using arthroscopy[J]. Chinese Journal of Tissue Engineering Research, 2019, 23(32): 5117-5125.

Figures/Tables 7

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