Two different kinds of fixation materials in repair of distal clavicle fracture: stability of reconstruction

doi:10.3969/j.issn.2095-4344.2014.26.007

Abstract

Abstract:

BACKGROUND: For distal clavicle fracture, clavicular hook plate and Kirschner wire tension band were used in the clinic, but they cannot keep the dual function of stability and functional protection. However, the application of microporous locking plate of distal clavicle makes it possible to double efficacy.
OBJECTIVE: To compare and analyze the clinical outcomes of distal clavicle microporous locking plate and clavicular hook plate.
METHODS: From March 2011 to March 2013, 40 patients with distal clavicle fractures were involved in this study. They were divided into two groups with the voluntary principles: distal clavicle microporous locking plate group and clavicular hook plate group. We compared and observed perioperative indicators (operation time, blood loss, and hospitalization days), clinical curative effects (University of California at Los Angeles scoring system and American Shoulder and Elbow Surgeons Scale), the score of shoulder joint function (Karlsson standard) and the overall treatment (removed the plate and functional training costs).
RESULTS AND CONCLUSION: All patients successfully underwent surgery. At 1 year after surgery, internal fixators were taken out. Necessary relevant rehabilitation training was performed for more than 3 months. There was no significant difference in perioperative indicators (P > 0.05). However, clinical curative effects and the score of Karlsson shoulder joint function showed significant advantages in the microporous locking plate group (P < 0.05). Although the distal clavicle microporous locking plate material cost was high, but there was no significant statistic difference in the overall treatment for better protection shoulder function (P > 0.05). We draw the conclusion that distal clavicle microporous locking plate can effectively reconstruct the stability of the fracture site, and better retain the function of the joints at the same time.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

全文链接：

Key words: clavicle, fractures, bone, internal fixators, shoulder joint

CLC Number:

R318

Cai Teng, Chen Yong . Two different kinds of fixation materials in repair of distal clavicle fracture: stability of reconstruction[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(26): 4136-4141.

Figures/Tables 9

References

[1]Martetschläger F, Kraus TM, Schiele CS ,et al. Treatment for unstable distal clavicle fractures (Neer 2) with locking T-plate and additional PDS cerclage. Knee Surg Sports Traumatol Arthrosc. 2013;21(5):1189-1194.
[2]Tan HL, Zhao JK, Qian C,et al. Clinical results of treatment using a clavicular hook plate versus a T-plate in neer type II distal clavicle fractures. Orthopedics. 2012;35(8):e1191-1197.
[3]Rieser GR, Edwards K, Gould GC, et al. Distal-third clavicle fracture fixation: a biomechanical evaluation of fixation. J Shoulder Elbow Surg. 2013;22(6):848-855.
[4]Liu Q, Miao J, Lin B,et al. Surgical treatment for unstable distal clavicle fracture with micromovable and anatomical acromioclavicular plate. Int J Med Sci. 2012;9(4):301-305.
[5]Robertson GA, Wood AM, Bakker-Dyos J,et al.The epidemiology, morbidity, and outcome of soccer-related fractures in a standard population. Am J Sports Med. 2012; 40(8):1851-1857.
[6]Banerjee R, Waterman B, Padalecki J,et al. Management of distal clavicle fractures. J Am Acad Orthop Surg. 2011;19(7): 392-401.
[7]Yang SW, Lin LC, Chang SJ,et al. Treatment of acute unstable distal clavicle fractures with single coracoclavicular suture fixation. Orthopedics. 2011;34(6):172.
[8]Oh JH, Kim SH, Lee JH ,et al. Treatment of distal clavicle fracture: a systematic review of treatment modalities in 425 fractures. Arch Orthop Trauma Surg. 2011;131(4):525-533.
[9]Klein SM, Badman BL, Keating CJ, et al. Results of surgical treatment for unstable distal clavicular fractures. J Shoulder Elbow Surg. 2010;19(7):1049-1055.
[10]Yu C, Sun YH, Zhao CQ, et al. Treatment of distal clavicle fracture with distal radius volar locking compression plate. Chin J Traumatol. 2009;12(5):299-301.
[11]Bhatia DN, Page RS. Surgical treatment of lateral clavicle fractures associated with complete coracoclavicular ligament disruption: Clinico-radiological outcomes of acromioclavicular joint sparing and spanning implants. Int J Shoulder Surg. 2012; 6(4):116-120.
[12]Ishimaru D, Ogawa H, Wakahara K,et al. Hip pads reduce the overall risk of injuries in recreational snowboarders. Br J Sports Med. 2012;46(15):1055-1058.
[13]付敏. 两种方法治疗肩锁关节脱位和锁骨远端骨折的临床对比分析[J].中外医学研究,2013,11(2):130-131.
[14]余胜文,刘捍东,张冰,等. 锁骨钩钢板治疗锁骨远端骨折及肩锁关节脱位86例体会[J].临床骨科杂志,2013,16(1):107.
[15]丁红,许晓跃,许欣,等. 两种不同手术方法治疗伴有喙锁韧带损伤的锁骨远端骨折疗效分析[J].中国骨与关节损伤杂志,2012, 27(1):58-59.
[16]Zhu YY, Cui HY, Jiang PQ,et al. Complications of treatment of acromioclavicular joint dislocation and unstable distal clavicular fracture with clavicular hook plate. Zhongguo Gu Shang. 2013;26(11):927-931.
[17]Deng Z, Cai L, Ping A, et al. Anatomical Research on the Subacromial Interval Following Implantation of Clavicle Hook Plates. Int J Sports Med. 2014. [Epub ahead of print]
[18]Reška M, Kone?ný J, Kašpar M, et al. Stabilisation of the dislocated acromioclavicular joint and lateral fractures of the clavicle using a hook plate. Rozhl Chir. 2013;92(3):143-150.
[19]Jensen G, Katthagen JC, Alvarado LE ,et al. Has the arthroscopically assisted reduction of acute AC joint separations with the double tight-rope technique advantages over the clavicular hook plate fixation? Knee Surg Sports Traumatol Arthrosc. 2014;22(2):422-430.
[20]Pereira-Graterol E, Álvarez-Díaz P, Seijas R,et al. Treatment and evolution of grade III acromioclavicular dislocations in soccer players. Knee Surg Sports Traumatol Arthrosc. 2013; 21(7):1633-1635.
[21]Tiren D, van Bemmel AJ, Swank DJ,et al. Hook plate fixation of acute displaced lateral clavicle fractures: mid-term results and a brief literature overview. J Orthop Surg Res. 2012;7:2.
[22]Wu K, Chang CH, Yang RS. Comparing hook plates and Kirschner tension band wiring for unstable lateral clavicle fractures. Orthopedics. 2011;34(11):e718-723.
[23]Good DW, Lui DF, Leonard M,et al. Clavicle hook plate fixation for displaced lateral-third clavicle fractures (Neer type II): a functional outcome study. J Shoulder Elbow Surg. 2012; 21(8):1045-1048.
[24]Ding M, Ni J, Hu J,et al. Rare complication of clavicular hook plate: clavicle fracture at the medial end of the plate. J Shoulder Elbow Surg. 2011;20(7):e18-20.
[25]Di Francesco A, Zoccali C, Colafarina O,et al. The use of hook plate in type III and V acromio-clavicular Rockwood dislocations: clinical and radiological midterm results and MRI evaluation in 42 patients. Injury. 2012;43(2):147-152.
[26]Li N, Li G, Wang SS, et al. AO clavicular hook plate for the treatment of fresh Tossy type III acromioclavicular joint dislocation in 28 patients. Zhongguo Gu Shang. 2011;24(3): 205-207.
[27]Bhattacharyya R, Sharma K, Mukherjee P. Clavicle Hook Plate for Neer Type II Lateral Clavicle Fractures. J Orthop Trauma. 2011;25(3):e30.
[28]Liu HH Chou YJ, Chen CH, et al. Surgical treatment of acute acromioclavicular joint injuries using a modified Weaver-Dunn procedure and clavicular hook plate. Orthopedics. 2010;33(8). doi: 10.3928/01477447-20100625-10.
[29]Bisbinas I, Mikalef P, Gigis I, et al. Management of distal clavicle fractures. Acta Orthop Belg. 2010;76(2):145-149.
[30]周荣.锁骨外侧锁定钢板治疗锁骨远端骨折[J].临床骨科杂志, 2012,15(5):599.