A systematic review and meta-analysis comparing the use of hook plates and superior plates in the treatment of displaced distal clavicle fractures

Malik, Shahbaz S.; Tahir, Mohd Faizal Mat; Remtulla, Mohammedabbas; Malik, Sheraz S.; Jordan, Robert W.

doi:10.1007/s00402-021-04287-z

Cited by 11 publications

(13 citation statements)

References 59 publications

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“…A recent meta-analysis of 1261 patients by Malik et al comparing hook plate and superior plate for treatment of displaced distal clavicle fractures found that the hook plate had a significantly higher overall complication rate (32.7%) than the superior plate (12.7%, OR = 6.3). Hook plate revealed 11.3% acromial osteolysis, 2.8% peri-prosthetic fracture, 1.6% shoulder stiffness, 1.6% impingement, 1.2% infections, and 0.35% rotator cuff tear [ 31 ]. Using a superior plate alone caused 11.7% of implants to be removed due to pain or cosmesis and 0.45% infection.…”

Section: Discussionmentioning

confidence: 99%

“…Using a superior plate alone caused 11.7% of implants to be removed due to pain or cosmesis and 0.45% infection. However, they showed a similar union rate (~ 97%) and CMS score [ 31 ]. Another recent meta-analysis comparing different internal fixation techniques has demonstrated that locking compression plates + coracoclavicular fixation is the most effective and has the least number of complications [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…With the help of the subacromial hook, the body of the plate acts as a depressor, gently pressing the medial fracture fragment down, facilitating bone union and early postoperative mobilization [ 23 , 33 , 34 ]. On the other hand, surgical complications associated with the hook plate were found to be more than plate and screw fixation [ 2 , 4 , 31 ]. Inflammation of the subacromial space, impingement of the rotator cuff, osteolysis of the acromion (27%), and periprosthetic fractures (22%) are all potential consequences of hook placement [ 1 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

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Comparison of hook plate versus T-plate in the treatment of Neer type II distal clavicle fractures: a prospective matched comparative cohort study

et al. 2022

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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 trauma centers. Patients with distal clavicle fractures Neer type II were assessed for union and the Constant-Murley score (CMS) at 1-, 3-, and 6-month follow-ups. Inadequate radiographic consolidation > 6 months after surgery was defined as non-union. Subscales of CMSpain, CMSactivities of daily living, CMSrange of motion (ROM), and CMSstrength were also compared between groups. According to recommendations, the implant was removed after union confirmation in the hook plate at a planned second surgery. Results Sixty consecutive patients were enrolled: 30 in the T-plate group and 30 in the hook plate group. CMS showed similar functional outcomes for T-plates and hook plates at all follow-ups (Month 6: 92.0 vs. 91.7, P = 0.45). However, on the month 1 follow-up, the T-plate group scored higher than the hook plate group for ROM and pain (CMSpain = 13.0 vs. 12.3, P = 0.03; CMSROM = 35.2 vs. 33.2, P = 0.002). Despite this, Pain, ROM, and other CMS domains were comparable between groups (P > 0.05). The mean time to union was 2.5 + 1.4 months for the T-plate group and 2.3 + 1.6 months for the hook plate group (P = 0.44). There was one fixation failure in each group and one periprosthetic fracture in the hook plate group (two revisions for the hook plates and one for T-plates, P = 1.00). Non-union and other complications were not observed. Conclusion Both surgical approaches resulted in full recovery and good function. However, in the hook plate group ROM and pain scores were lower at 1 month. Standard non-locking T-plates are a viable alternative to hook plates with low cost and promising outcomes for treating displaced distal clavicle fractures.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Comparison of hook plate versus T-plate in the treatment of Neer type II distal clavicle fractures: a prospective matched comparative cohort study

et al. 2022

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“…However, it also results in many complications, including acromial osteolysis, rotator cuff tears, rotator cuff impingement, peri‐implant fracture, and serious shoulder pain. In addition, many researchers have reported a high secondary surgery rate for implant removal 15 . In the last few decades, locking plates have been advocated for managing distal clavicular fractures.…”

Section: Introductionmentioning

confidence: 99%

Comparing the Efficacy of Anatomical Locked Plate Fixation with Coracoclavicular Ligament Augmentation to Hook Plate Fixation in Treating Distal Clavicle Fractures

Wang

Xue

et al. 2022

Orthopaedic Surgery

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Objective Hook plate fixation is the traditional method for treating distal clavicle fractures. However, in recent years, locked plate applications have emerged as a promising treatment method. This study aimed to compare the short‐ and mid‐term clinical efficacy of anatomical locked plate fixation with coracoclavicular ligament augmentation using anchor nails to that of hook plate fixation in treating distal clavicle fractures. Methods This was a retrospective single‐center cohort study investigating patients with distal clavicle fractures treated between January 2016 and February 2019 in Zhongnan Hospital of Wuhan University. Fifty‐nine eligible patients who underwent either anatomical locked plate fixation with coracoclavicular ligament augmentation using anchor nails (LPF&CLA group; 20 patients) or clavicle hook plate fixation (CHPF group; 39 patients) were included. The visual analog scale (VAS) and Constant–Murley shoulder scores were used to assess shoulder function. In addition, the coracoclavicular distance between the affected and unaffected shoulders (ΔCC distance) was measured to assess the reduction. Patients were followed up at 3 months, 6 months, and 1 year postoperatively. The comparisons between the two groups were made using Student's t‐test, chi‐square test, or Fisher's exact test, if appropriate. Results Preoperative VAS scores were similar in both groups. At 3‐ and 6‐month follow‐up, the VAS score was significantly higher in the CHPF group than in the LPF&CLA group. In contrast, the Constant–Murley shoulder score was significantly lower in the CHPF group than in the LPF&CLA group. When the hook plates were removed, there was no statistical difference in both VAS (0.2 ± 0.4 in LPF&CLA group vs. 0.5 ± 0.5 in CHPF group, p = 0.05) and Constant–Murley shoulder (96.1 ± 3.1 in LPF&CLA group vs. 93.8 ± 5.2 in CHPF group, p = 0.08) scores at the last follow‐up. Postoperatively, the ΔCC distance was 2.37 ± 1.93 mm in the LPF&CLA group and −1.56 ± 1.34 mm in the CHPF group. One year after surgery, ΔCC distance increased to 3.96 ± 1.17 mm in the LPF&CLA group and to −0.89 ± 1.39 mm in the CHPF group. Conclusion For distal clavicle fractures in which the coracoclavicular ligament is disrupted, anatomical locked plate fixation with coracoclavicular ligament augmentation achieved better functional recovery and less pain than hook plate fixation at the 6‐month follow‐up. However, the hook plate provided better reduction throughout the follow‐up period and shoulder pain could be relieved using removal surgery. Therefore, locked plates with coracoclavicular ligament augmentation favors post‐surgery pain relief while harvesting similar functional outcomes to hook plate fixation

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“…Distal clavicle fractures account for about 10%-30% of all clavicle fractures [1,2] and 50% of nonunion cases [3]. Injuries to the lateral third of the clavicle could lead to disruption of the coracoclavicular (CC) ligament compromising the stability of the fracture and the acromioclavicular joint (ACJ), thus, resulting in higher rates of malunion and nonunion [1].…”

Section: Introductionmentioning

confidence: 99%

Hook Plate Versus Distal Locking Plate for the Fixation of Unstable Distal Clavicle Injuries, Outcomes and Complications: A Meta-Analysis

Elrih¹,

Quinlan²

2022

Cureus

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Numerous interventions are advised for the surgical management of distal clavicle fractures. Hook plate (HP) and distal locking plate (DLP) are among the commonly used techniques; nonetheless, no single procedure is deemed to be the benchmark treatment. Thus, the aim of the study is to conduct a comparative analysis, hopefully, to recommend the superior method between the two operations.PubMed, Embase via Ovid and Web of science were electronically searched between January 2000 and to date for studies directly comparing HP to DLP. Comparative retrospective/prospective and randomized studies were incorporated. Constant-Murley score "CMS" at a minimum of 12 months, pain visual analogue scale "VAS", coracoclavicular distance "CCD" and reported complications were analysed. Review manager software was used for the statistical analyses.The total number of patients was 523; 274 (52.3%) with HP and 249 (47.6%) with DLP, 81 of which were associated with CC reconstruction. The mean follow up was 38.7 and 37.03 months for HP and DLP, respectively. CMS leaned towards the DLP group with no statistically significant difference (P=0.06). VAS was in favour of the DLP with again no statistically significant difference (P=0.12). In terms of CCD, the comparison favoured the HP with a lesser CCD postoperatively and a statistically significant difference (P<0.05). Complications were significantly higher in the HP group (P<0.0001).Contrary to our hypothesis, though HP did show a better radiological outcome; nonetheless, DLP did demonstrate a better functional result with a lesser rate of complications and the ability to retain the implant avoiding a second surgery.

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A systematic review and meta-analysis comparing the use of hook plates and superior plates in the treatment of displaced distal clavicle fractures

Cited by 11 publications

References 59 publications

Comparison of hook plate versus T-plate in the treatment of Neer type II distal clavicle fractures: a prospective matched comparative cohort study

Comparison of hook plate versus T-plate in the treatment of Neer type II distal clavicle fractures: a prospective matched comparative cohort study

Comparing the Efficacy of Anatomical Locked Plate Fixation with Coracoclavicular Ligament Augmentation to Hook Plate Fixation in Treating Distal Clavicle Fractures

Hook Plate Versus Distal Locking Plate for the Fixation of Unstable Distal Clavicle Injuries, Outcomes and Complications: A Meta-Analysis

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