Clinical efficacies of coracoclavicular ligament reconstruction using suture anchor versus hook plate in the treatment of distal clavicle fracture

Yan, Haiwei; Li, L; Wang, R C; Yang, Yongbo; Xie, Yuyuan; Tang, Jun; Shi, Zhanying

doi:10.1016/j.otsr.2017.07.006

Cited by 21 publications

(5 citation statements)

References 16 publications

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“…Despite high rates of union, the use the HP is particularly contentious due to high rates of irritation requiring hardware removal reported in the literature (62.5%) [ 6 ]. This has led to some authors routinely removing HP metalwork at four-six months to reduce the risk of postoperative complications [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

The Management of Distal Clavicle Fractures – A Survey of UK Shoulder and Elbow Surgeons

Sharma¹,

Modi²,

Armstrong³

et al. 2021

Cureus

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Section: Discussionmentioning

confidence: 99%

The Management of Distal Clavicle Fractures – A Survey of UK Shoulder and Elbow Surgeons

Sharma¹,

Modi²,

Armstrong³

et al. 2021

Cureus

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“…In several comparative studies, CC flexible fixation has been reported as providing satisfactory results. Yan et al 52) compared the clinical results of CC ligament reconstruction using suture anchors with those using an autologous gracilis tendon (21 patients) and a hook plate (21 patients) in a total of 42 patients. All patients in both groups achieved bony union without major complications and satisfactory clinical outcome at the last follow-up.…”

Section: Hook Platementioning

confidence: 99%

Current Concepts for Classification and Treatment of Distal Clavicle Fractures

Kim

et al. 2020

Clin Orthop Surg

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The management of distal (lateral third) clavicle fractures can be challenging because of difficulty in distinguishing subtle variations in the fracture pattern, which may be suggestive of potential fracture instability. 1) An analysis of the frequency of distal clavicle fractures by age and sex has revealed that they occur most often in men between 30 and 50 years of age and secondarily in individuals (both men and women) over 70 years of age. 2) Distal clavicle fractures are less common than clavicle midshaft fractures and account for 10%-30% of all clavicle fractures. Roughly 30%-45% of all clavicle nonunion fractures occur distally. [3][4][5][6][7][8] Distal clavicle fractures may be treated conservatively or surgically, and there is no gold standard or consensus in the field. Importantly, however, conservative treatment of distal clavicle fractures may result in nonunion or pseudoarthrosis; therefore, surgical treatment is recommended when these fractures are unstable. Various strategies for surgical treatment of distal clavicle fractures have been reported, including precontoured locking plate fixation, hook plate fixation, coracoclavicular (CC) fixation (using a suture anchor, suture button device, or screw), ten-

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“…Asadollahi and Bucknill 2 reported no significant difference in functional outcome and union rate among hook plate, CC stabilization, and locking plate in a systematic review comprising 634 patients. However, their most important limitation was the inclusion of the study of Yan et al, 70 which is biased because it primarily excluded patients with nonunions. Boonard et al 4 compared the functional outcome of 5 operative methods (CC fixation, hook plate, locking plate, TBW, and transacromial KW fixation) in 547 patients and showed that CC fixation and locking plates resulted in higher CMS and UCLA scores when compared with the other surgical methods.…”

Section: Discussionmentioning

confidence: 99%

Outcomes, Union Rate, and Complications After Operative and Nonoperative Treatments of Neer Type II Distal Clavicle Fractures: A Systematic Review and Meta-analysis of 2284 Patients

Uittenbogaard

Haan³

et al. 2021

Am J Sports Med

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Background: As nonoperative treatment of Neer type II distal clavicle fractures is associated with nonunion rates up to 33%, operative treatment is frequently advocated. However, evidence is lacking regarding which operative treatment to perform and whether this is superior to nonoperative treatment in terms of functional outcome and complication rate. Purpose: (1) To evaluate which surgical technique in the treatment of Neer type II distal clavicle fractures is optimal with regard to patient-reported outcomes and union and complication rates. (2) To review nonoperatively treated patients. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review of the literature and meta-analysis were performed on January 27, 2021, in PubMed, Embase, CENTRAL, CINAHL/EBSCO, Web of Science/Clarivate Analytics, and SPORTDiscus/EBSCO. The search included all studies regarding nonoperative and operative treatment of Neer type II distal clavicle fractures with a minimum of 20 patients and follow-up of 12 months. The primary and secondary outcomes were patient-reported outcome measures at 12 months and union, complication, and revision rates. Results: A total of 59 articles were included involving 2284 patients. Coracoclavicular fixation, hook plate, transacromial pins, alternative plate, tension band wire/K-wire, a combination of surgical techniques, and a nonoperative group were described. Hook plates showed lower Constant-Murley scores as compared with coracoclavicular fixation (standard mean difference, –0.77; 95% CI, –1.26 to –0.28; P = .002). However, no significant difference was seen when the hook plate was compared with the locking plate and tension band wire/K-wire groups, and no significant difference in union rate was seen among all operative treatment groups. Operatively treated patients had significantly higher union rates than patients treated nonoperatively (standard mean difference: 0.05; 95% CI, 0.01 to 0.37; P = .004). Conclusion: Patients treated with hook plates showed significantly lower Constant-Murley scores and higher complication and revision rates as compared with those treated with coracoclavicular fixation, without differences in union rate. Higher Constant-Murley scores were seen in those patients with supplemental coracoclavicular fixation when using locking. Nonoperatively treated patients showed good functional outcome despite the 31% nonunion rate, although future studies are necessary to substantiate this conclusion. When using a locking plate, additional craniocaudal fixation showed significant better functional outcome.

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Clinical efficacies of coracoclavicular ligament reconstruction using suture anchor versus hook plate in the treatment of distal clavicle fracture

Abstract: Level II, low-powered prospective randomized trial.

Cited by 21 publications

References 16 publications

The Management of Distal Clavicle Fractures – A Survey of UK Shoulder and Elbow Surgeons

The Management of Distal Clavicle Fractures – A Survey of UK Shoulder and Elbow Surgeons

Current Concepts for Classification and Treatment of Distal Clavicle Fractures

Outcomes, Union Rate, and Complications After Operative and Nonoperative Treatments of Neer Type II Distal Clavicle Fractures: A Systematic Review and Meta-analysis of 2284 Patients

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