Arch Hand Microsurg.  2017 Dec;22(4):247-255. 10.12790/ahm.2017.22.4.247.

Comparison of Locking Compression Plate Superior Anterior Clavicle Plate with Suture Augmentation and Hook Plate for Treatment of Distal Clavicle Fractures

• Choi JC
• Song WS
• Kim WS
• Kim JM
• Byun CW

• KMID: 2406128
• DOI: http://doi.org/10.12790/ahm.2017.22.4.247

Abstract

PURPOSE
The purpose of this study was to compare the results (or effectiveness) of anterior superior locking compression plate (LCP) with suture augmentation and hook plate in treatment of Neer type II distal clavicle fracture.
METHODS
From April 2009 to October 2015, 34 patients with distal clavicle fracture of Neer type II were surgically treated. Eleven patients were operated with LCP-suture augmentation (group I) and 23 patients underwent by hook plate (group II). Radiographic evaluation and functional evaluation using Korean Shoulder Society (KSS) scoring system were performed.
RESULTS
Radiographic unions were achieved in all cases and mean radiographic union period was not different either as 4.1 months (range 3-14 months), 5.0 months (range 3-14 months) in group I and 3.7 months (range 3-11 months) in group II. However, KSS score was 87.6 (range 82-92) in group I, and was 63.4 (range 32-86) in group II (p < 0.05). One case of osteolysis and no case of frozen shoulder were found in group I while 6 cases of osteolysis and 3 cases of frozen shoulder were found in group II.
CONCLUSION
LCP-suture augmentation is considered a more effective method, compared to hook plate osteosynthesis for distal clavicle fracture of Neer type II, producing better clinical outcomes and lower incidence of complications.

Keyword

Clavicle; Distal clavicle fracture; Locking compression plate superior anterior clavicle plate; Hook plate

MeSH Terms

Bursitis
Clavicle*
Humans
Incidence
Methods
Osteolysis
Shoulder
Sutures*

Figure

• 

  Fig. 1 (A) Intraoperative photograph of the left shoulder of a 38-year-old male shows left distal clavicle fracture. After the exposure of fracture fragment, displacement of major fragment is observed. (B) An additional mersilene tape is applied to fix plate and bony fragments with reduction. (C) Reduction is identified by intraoperative C-arm intensifier (D) The fracture is reducted and fixated with a plate, screw and additional 2 mersilene tapes and an Ethibond binding.

• 

  Fig. 2 (A) Preoperative radiograph of the left shoulder of a 38-year-old male shows left distal clavicle fracture. (B) This is postoperative radiograph with locking compression plate superior clavicle plate. (C) At 3 months follow-up, bony union is achieved.

• 

  Fig. 3 (A) Postoperative radiograph of the left shoulder of a 35-year-old male shows right distal clavicle fracture. (B) At 6 months follow-up, the radiograph shows osteolysis of acromion by the Hook plate. (C) At 8 months follow-up, Hook plate was removed.

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