Retrospective comparative study of arthroscopy assisted loop-plate suture technique and a Hook plate for the treatment of distal clavicle fractures

Abstract

Purpose To compare the clinical effects of hook plate and AALS technique in the treatment of acute Neer II distal clavicular fracture. Methods 33 patients with Neer II distal clavicular fracture were included in this study. 15 patients were treated internal fixation with clavicular hook plate. 18 patients underwent fracture reduction with AALS technique. Constant-Murley and VAS scores were used to evaluate shoulder joint function and pain degree during follow-up. Karlsson score and shoulder joint X-ray was used to evaluate patients' satisfaction and the loss of reduction respectively. Results There were significant differences in amount of bleeding, Constant-Murley score and Karlsson score between these two groups (P<0.05). In the AALS group, we observed 3 cases with rotator cuff injury, 1 case with labrum injury during the operation. Two patients in AALS group had slight loss of reduction, but with no requirement of removal of internal fixation owing to discomfort. In hook plate group, 5 patients complained discomfort in shoulder movement and limited function after operation. At the last follow-up, 3 patients suffered from subacromial osteolysis accompanied by acromial impingement pain, and 2 patients with mild reduction loss. Conclusion For patients with Neer IIB distal clavicle fracture, AALS technique is superior to hook plate in shoulder joint function recovery and pain performance after operation, which is probably a novel reliable choice.