Clinical outcomes of treating Neer II distal clavicle fractures with anatomical locking plate and clavicular hook plate

Abstract

Objective To compare the clinical outcomes of treating Neer type Ⅱ distal clavicle fractures with anatomical locking plate and clavicular hook plate.Methods A retrospective review of 45 cases of Neer Ⅱ distal clavicular fractures treated from August 2009 to February 2013 was conducted.Among them 20 cases were treated with anatomical locking plate (group A),while 25 cases were treated with clavicular hook plate (group B).Preoperative conditions of the patients in the two groups were comparable (P ＞ 0.05).Postoperatively shoulder functions were evaluated using the Constant-Murley score system.Postoperative radiographic findings,fracture healing,hardware position and complications in patients of the two groups were also studied and compared.Results The mean duration of postoperative follow-up was 11.4 months(range,10 to 13 months).There were no nonunion,infection and other complications.The breakage of internal fixation hardware occurred in 1 patient treated with clavicular hook plate 6 months postoperatively.The Constant-Murley scores at postoperative 1,3,6 months and at last follow-up after hardware removal were the scores of 88.6 ± 6.2,90.6 ± 4.8,96.6 ± 3.6 and 98.8 ± 1.2,respectively,for the anatomical locking plate group,and 76.6 ± 4.4,84.4 ± 4.6,87.2 ± 3.8 and 92.8 ± 4.3,respectively,for the clavicular hook plate group.Shoulder functions in group A at all the follow-up time points were better than these in group B.The differences between these two groups were statistically significant (P ＜ 0.01).Conclusion Satisfactory results are obtained in both groups.However,anatomical locking plate fixation is easier to operate,leads to more reliable fixation,fewer complications and better shoulder function recovery.It is therefore the treatment of choice for Neer type Ⅱ distal clavicular fractures. Key words: Clavicle; Fracture fixation, internal; Treatment outcome