Operative management of lateral third clavicle fractures: a comparison of internal fixation methods View Full Text


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Article Info

DATE

2021-11-26

AUTHORS

Patrick Hickland, Christopher Goodland, Sunil Zachariah, Lynn E Murphy, Martyn Neil

ABSTRACT

PurposeClavicle fractures in the lateral third are associated with more complications. Various methods of internal fixation exist; however, there is no consensus which should be employed. The purpose of this study was to evaluate the outcomes of these various methods in our regional trauma unit.MethodsWe performed a retrospective review of patients who underwent internal fixation of a lateral clavicle fracture in our unit between 1 August 2014 and 31 July 2019. Demographic and outcome data were extracted from electronic care records and imaging systems.ResultsIn total, 44 patients were included, with the following demographics: mean age 26 years, 63.6% male, 65.9% high-energy injury, 68.2% Neer II fracture. The following operations were performed: hook plate fixation (HPF) = 10, locking plate fixation (LPF) = 16, coracoclavicular ligament reconstruction (CCLR) = 12, and LPF + CCLR = 6. Patients having LPF had a significantly larger post-operative coracoclavicular distance (7.6 mm vs 13.5 mm, p < 0.01), and trends towards a lesser decrease in CCD (9.9 mm vs 12.6 mm, p = 0.37) and incomplete ACJ reduction (50.0% vs 89.3%, p = 0.11). There was a significantly higher re-operation rate after HPF (100% vs 23.5%, p < 0.01). There were no differences in time to union or duration of follow-up.ConclusionIn our unit there is no clearly favoured method of internal fixation of lateral clavicle fractures. When LPF is used, there should be consideration of concomitant CCLR. The high rate of re-operation after HPF is concordant with previous research. More... »

PAGES

1-7

References to SciGraph publications

  • 2014-05-29. Comparison of single coracoclavicular suture fixation and hook plate for the treatment of acute unstable distal clavicle fractures in JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH
  • 2020-03-27. Hook versus locking plate fixation for Neer type-II and type-V distal clavicle fractures: a retrospective cohort study in EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY
  • 2014-09-09. TightRope versus clavicular hook plate fixation for unstable distal clavicular fractures in EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY
  • 2010-10-22. Treatment of distal clavicle fracture: a systematic review of treatment modalities in 425 fractures in ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY
  • 2019-03-07. Surgical treatment of Neer type II and type V lateral clavicular fractures: comparison of hook plate versus superior plate with lateral extension: a retrospective cohort study in EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY
  • 2014-04-15. Comparison of the efficacy of a distal clavicular locking plate versus a clavicular hook plate in the treatment of unstable distal clavicle fractures and a systematic literature review in INTERNATIONAL ORTHOPAEDICS
  • 2018-03-22. Fixation method for treatment of unstable distal clavicle fracture: systematic review and network meta-analysis in EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY
  • 2019-04-03. Clavicle fractures in adults; current concepts in EUROPEAN JOURNAL OF TRAUMA AND EMERGENCY SURGERY
  • 2017-03-20. Comparative analysis of locking plate versus hook plate osteosynthesis of Neer type IIB lateral clavicle fractures in ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY
  • 2008-12-03. Comparison of the efficacy of hook plate versus tension band wire in the treatment of unstable fractures of the distal clavicle in INTERNATIONAL ORTHOPAEDICS
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    http://scigraph.springernature.com/pub.10.1007/s00590-021-03173-z

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    http://dx.doi.org/10.1007/s00590-021-03173-z

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    https://www.ncbi.nlm.nih.gov/pubmed/34825989


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