“…In the systematic reviews performed by Panagopoulos et al and Uittenbogaard et al, the authors summarize that the surgical treatment of Neer type II fractures has a high complication rate in general, but the use of hook plates leads to poorer clinical outcomes compared to other modes of xation [1,2]. In the present study, a mean SSV of 91.0 was achieved, which is comparable to the literature [22][23][24], and does not fully agree with the poor results of Uittenbogaard and Panagopoulos [1][2]. Interestingly, the mean CS of 80.9 is below of what is described in the literature for locking plate xation, AC Joint trans xation, tension band wiring and hook plate xation as well [2].…”
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.
“…In the systematic reviews performed by Panagopoulos et al and Uittenbogaard et al, the authors summarize that the surgical treatment of Neer type II fractures has a high complication rate in general, but the use of hook plates leads to poorer clinical outcomes compared to other modes of xation [1,2]. In the present study, a mean SSV of 91.0 was achieved, which is comparable to the literature [22][23][24], and does not fully agree with the poor results of Uittenbogaard and Panagopoulos [1][2]. Interestingly, the mean CS of 80.9 is below of what is described in the literature for locking plate xation, AC Joint trans xation, tension band wiring and hook plate xation as well [2].…”
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.
“…Titles and abstracts were screened, and 18 articles for full-text evaluation were retrieved. Seven studies met the predetermined eligibility criteria [ 21 – 24 , 28 – 30 ], and three additional studies were included after citation screening [ 31 – 33 ] (Fig. 1 ).…”
Section: Resultsmentioning
confidence: 99%
“…1 ). There were five retrospective [ 21 , 24 , 28 , 31 , 32 ] and five prospective cohort studies [ 22 , 23 , 29 , 30 , 33 ]. Fig.…”
Background
To determine the incidence of concomitant intra-articular glenohumeral injuries in patients undergoing surgical management from distal clavicle fractures (DCF) with shoulder arthroscopy and their impact on outcome.
Methods
This systematic review was conducted following the PRISMA guidelines. PubMed, EMBASE, and Virtual Health Library databases were accessed in October 2021. All the clinical studies evaluating the surgical management of DCF and using concomitant intra-operatory shoulder arthroscopy were included. Studies that did not specify the concomitant injury type were not eligible. Data from the incidence of intra-articular glenohumeral injuries, injury type, length of the follow-up, and clinical outcomes were retrieved. The quantitative content assessment was performed using the STROBE statement checklist. Evaluation of the publication bias of the included studies was performed using the risk of bias assessment tool for systematic reviews.
Results
Data from five retrospective and five prospective cohort studies were analyzed. Eight of the included studies were conducted on patient cohorts with Neer type II injuries. Data pooling revealed a mean of 17.70% of concomitant glenohumeral injuries, whereas 84.21% of them required additional surgical management (Table 1). Rotator cuff injuries, labral tears, and biceps pulley lesions were the most common concomitant injuries.
Conclusion
Preoperative MRI or diagnostic arthroscopy to evaluate glenohumeral associated injuries to DCF should be recommended.
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