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

Abstract

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.

Arthroscopically Assisted Coracoclavicular (CC) Stabilization Using a Suture Button Device for Lateral Clavicle Fractures With CC Ligament Injury

“…Malik et al [16] reported that the shoulder function scores after arthroscopically assisted CC ligament reconstruction ranged from 81.8 to 96.2, as assessed by the Constant-Murley score (CMS). For other fixation methods, the mean CMS was 85.3 to 88 in the TBW group [23,24], 79.9 to 93.3 in the hook plate group, and 82.8 to 98.1 in the locking plate group [25,26]. The present method accomplished relatively better ROM recovery and better clinical outcomes compared with similar methods and other fixation methods, suggesting that arthroscopically assisted CC ligament reconstruction can be an optimal treatment for lateral clavicle fractures accompanied by ligament injury.…”

Arthroscopically Assisted Coracoclavicular (CC) Stabilization Using a Suture Button Device for Lateral Clavicle Fractures with CC Ligament Injury

“…Malik et al [ 23 ] reported that shoulder function scores after arthroscopically assisted CC ligament reconstruction ranged from 81.8 to 96.2, as assessed through the Constant–Murley score. For other fixation methods, the mean Constant–Murley score ranged from 85.3 to 88 in the TBW group [ 35 , 36 ], from 79.9 to 93.3 in the hook plate fixation group, and from 82.8 to 98.1 in the locking plate fixation group [ 25 , 37 ]. On the basis of these scores, arthroscopically assisted CC ligament reconstruction may be superior to other surgical procedures.…”