Treatment of unstable distal clavicle fractures (Neer type II): A comparison of three internal fixation methods

Xiong, Jie; Chen, Jianhai; Yu, Dian; Zhang, Dianying; Fu, Zhong-guo; Zhang, Peixun

doi:10.1177/0300060518788245

Cited by 26 publications

(28 citation statements)

References 10 publications

(14 reference statements)

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“…With respect to the 2 comparative studies, the first compared arthroscopic cortical button fracture stabilization with hooked plating, 9 while the second compared 3 techniques (arthroscopic cortical button stabilization, hooked plating, and locked plating). 34 During the data abstraction process, only data pertinent to the arthroscopic cases in these studies were incorporated when calculating means and SDs.…”

Section: Study Selectionmentioning

confidence: 99%

“…Concomitant injuries were reported in 3 12,16,34 of the 15 studies reviewed (Table 4). Ten of the 28 reported injuries involved the ipsilateral shoulder joint and included 5 labral injury variants, 3 rotator cuff tears, 1 glenoid fracture, and 1 scapular body fracture.…”

Section: Concomitant Injuriesmentioning

confidence: 99%

“…Many authors have also reported low complication rates. 7,34 The primary purpose of this study was to systematically review the literature, focusing on the clinical and radiographic results of arthroscopic fixation of unstable DCFs. The secondary purpose was to characterize the overall complication rate, focusing on major complications and subsequent reoperations.…”

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confidence: 99%

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Outcomes of Arthroscopic Fixation of Unstable Distal Clavicle Fractures: A Systematic Review

Yagnik¹,

Seiler²,

Vargas³

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: Surgical management of unstable distal clavicle fractures (DCFs) remains controversial. Traditional open techniques result in acceptable union rates but are fraught with complications. In response to these limitations, arthroscopic techniques have been developed; however, clinical outcome data are limited. Purpose: The primary purpose was to systematically evaluate the clinical and radiographic outcomes of arthroscopic fixation of unstable DCFs. The secondary purpose was to characterize the overall complication rate, focusing on major complications and subsequent reoperations. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review of the literature was performed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and included a search of the PubMed, Web of Science, Cochrane Register of Controlled Trials, EMBASE, and Scopus databases. English-language studies between 2008 and 2019 that reported on outcomes of patients with DCFs who underwent operative fixation using an arthroscopic or arthroscopically assisted surgical technique were included. Data consisted of patient characteristics, fracture type, surgical technique, concomitant injuries, union rates, functional outcomes, and complications. Results: A total of 15 studies consisting of 226 DCFs treated using an arthroscopically based technique were included in the systematic review. The majority of fractures were classified as Neer type II. Most (97%) of the fractures underwent arthroscopic fixation using a cortical button coracoclavicular stabilization surgical technique. Bony union was reported in 94.1% of the fractures. Good to excellent outcomes were recorded in most patients at the final follow-up. The Constant-Murley score was the most widely used functional outcome score; the pooled mean Constant score was 93.06 (95% CI, 91.48-94.64). Complications were reported in 14 of the 15 studies, and the overall complication rate was 27.4%. However, only 12% of these were considered major complications, and only 6% required a reoperation for hardware-related complications. Conclusion: Arthroscopic fixation of DCFs resulted in good functional outcomes with union rates comparable to those of traditional open techniques. While the overall complication profile was similar to that of other described techniques, there was a much lower incidence of major complications, including hardware-related complications and reoperations.

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Section: Study Selectionmentioning

confidence: 99%

Section: Concomitant Injuriesmentioning

confidence: 99%

mentioning

confidence: 99%

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Outcomes of Arthroscopic Fixation of Unstable Distal Clavicle Fractures: A Systematic Review

Yagnik¹,

Seiler²,

Vargas³

et al. 2021

Orthopaedic Journal of Sports Medicine

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“…Several surgical treatments are available for distal clavicle fractures, including a Kirschner wire tension band, coracoclavicular screw, distal clavicle locking plate (LP), clavicle hook plate (HP), and arthroscopic treatment. 4 Among these treatments, distal clavicle LPs and clavicle HPs are commonly used for the treatment of Neer type II distal clavicle fractures. The purpose of this study was to compare the clinical efficacy of these two surgical methods in the treatment of Neer type II distal clavicle fractures.…”

Section: Introductionmentioning

confidence: 99%

Comparative analysis of locking plates versus hook plates in the treatment of Neer type II distal clavicle fractures

Wang

Liang

et al. 2020

J Int Med Res

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Objective This study was performed to compare the clinical effects of locking plates (LPs) with those of hook plates (HPs) in the treatment of Neer type II distal clavicle fractures. Methods From August 2014 to April 2018, 64 patients with Neer type II distal clavicle fractures were treated in our department. The clinical effects were assessed with respect to the operation time, intraoperative blood loss, incision length, fracture healing, postoperative pain, postoperative complications, and postoperative shoulder joint function. Results There were no significant differences in the healing time, operation time, or intraoperative blood loss between the LP and HP groups. The incision length was significantly shorter in the LP than HP group, and the postoperative complication rate was significantly lower in the LP than HP group. The visual analog scale score, Constant–Murley score, and University of California Los Angeles score were significantly better in the LP than HP group. Conclusions Compared with HPs, the use of LPs involves a smaller incision in the treatment of Neer type II distal clavicle fractures and significantly reduces postoperative pain and complications. Therefore, priority can be given to the use of LPs in the treatment of Neer type II distal clavicle fractures.

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“…While hook plates showed good outcomes for fractures with comminuted distal bone fragments, various complications, such as peri-implant fracture, dislocation, and limited range of motion were reported [6,10,15]. On the other hand, plates that are fixed proximal to the acromioclavicular joint have been reported as leading to fewer complications than the hook plate, since the plates do not disturb the acromioclavicular joint motion [14,16,17]. However, complications such as plate fracture due to trauma, nonunion, and plate loosening can occur, albeit at a lower frequency, and some cases require re-operation [18,19].…”

Section: Introductionmentioning

confidence: 99%

Treatment of distal clavicle fractures using a Scorpion plate and influence of timing on surgical outcomes: a retrospective cohort study of 105 cases

Furuhata

Takahashi

Hayashi

et al. 2020

BMC Musculoskelet Disord

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Background: Plate fixation is an established method for treating unstable distal clavicle fractures. However, the appropriate timing of surgery for acute distal clavicle fractures remains unclear. The present study aimed to evaluate the clinical outcomes of osteosynthesis using a Scorpion plate and to assess the influence of surgery timing on the surgical outcomes for acute unstable distal clavicle fractures. Methods: We retrospectively reviewed 105 patients who underwent fixation for acute unstable distal clavicle fractures (Neer type II and V) using the Scorpion plate between 2008 and 2018. Patients were divided into early (45 patients) and delayed (60 patients) treatment groups based on the timing of the surgical intervention (within or after 7 days). The outcomes were postoperative complications (nonunion, peri-implant fracture, plate loosening, plate-related pain, and stiffness). We evaluated the outcomes from X-ray radiographs and clinical notes. Results: Among the 105 patients, nonunion, plate loosening, plate-related pain, and stiffness were observed in six patients (5.7%), four patients (3.8%), seven patients (6.7%), and one patient (1.0%), respectively. The nonunion rate was significantly higher in the delayed treatment group than that in the early treatment group (P = 0.036). Although the difference was not significant, plate loosening and stiffness were only observed in the delayed treatment group. Conclusion: Our results demonstrated that osteosynthesis using Scorpion plates achieved satisfactory surgical outcomes for unstable distal clavicle fractures. In addition, this study suggested that performing surgery within 6 days after injury is recommended to reduce postoperative complications.

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Treatment of unstable distal clavicle fractures (Neer type II): A comparison of three internal fixation methods

Cited by 26 publications

References 10 publications

Outcomes of Arthroscopic Fixation of Unstable Distal Clavicle Fractures: A Systematic Review

Outcomes of Arthroscopic Fixation of Unstable Distal Clavicle Fractures: A Systematic Review

Comparative analysis of locking plates versus hook plates in the treatment of Neer type II distal clavicle fractures

Treatment of distal clavicle fractures using a Scorpion plate and influence of timing on surgical outcomes: a retrospective cohort study of 105 cases

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