Comparing Hook Plates and Kirschner Tension Band Wiring for Unstable Lateral Clavicle Fractures

Wu, Karl; Chang, Chih Hung; Yang, Rong‐Sen

doi:10.3928/01477447-20110922-17

Cited by 27 publications

(16 citation statements)

References 28 publications

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“…However, several complications of hook plate were reported, such as subacromial impingement, bursitis, rotator cuff injury, and clavicle fracture at the medial end of the plate. 13,18,19) Plate fixation is one of the treatment options, but it is hard to achieve rigid fixation with ordinary plates due to the small size of the distal fragment. Pre-contoured superior locking plates were developed, and they have multiple 2.7 mm or 2.3 mm locking screw holes at the lateral end of the plate.…”

Section: Discussionmentioning

confidence: 99%

Anatomical Locking Plate with Additional K-wire Fixation for Distal Clavicle Fracture

Nam

Moon²,

Choi

2017

Clin Shoulder Elbow

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BACKGROUND: Neer type II distal clavicle fractures have the drawback of coracoclavicular instability and insufficient distal bony fragment, thereby making it difficult to achieve adequate fixation. Although various surgical treatments have been described for Neer type II fracture, the optimal treatment remains controversial. This study reports the clinical results and usefulness of anatomical locking plate with additional K-wire fixation.METHODS: A totally of 21 patients with type II distal clavicle fracture were included in the study. The surgical procedure reduced the fracture temporarily; it included insertion of one or two K-wire from the lateral margin of the distal fragment to the proximal fragment through the fracture site, followed by application and fixation of the locking plate. The bony union and migration of K-wire was evaluated in the follow-up radiography. The coracoclavicular distance and acromioclavicular joint arthrosis were assessed at the final follow-up. The Constant Score (CS) and Korean Shoulder Score (KSS) were evaluated for clinical scoring.RESULTS: Bone union was achieved in all cases. At the final follow-up, coracoclavicular distance of the injured shoulder was increased, as compared to the intact shoulder (p=0.002), with no accompanying clinical symptoms. No K-wire migration was observed. At the final follow-up, K-wire irritation was observed in two cases and acromioclavicular arthrosis in one case, with no other adverse effects. Pain visual analogue scale, CS, and KSS were improved in all cases.CONCLUSIONS: The method of anatomical locking plate with additional K-wire fixation could be useful in achieving beneficial clinical results.

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Section: Discussionmentioning

confidence: 99%

Anatomical Locking Plate with Additional K-wire Fixation for Distal Clavicle Fracture

Nam

Moon²,

Choi

2017

Clin Shoulder Elbow

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“…For the majority of younger patients with these fractures, operative treatment is more appropriate. A range of techniques are described for fixation of these injuries including; plating (hook-plate, locking T plates) [43, 44], coraco-clavicular screw [45], Kirschner wires [46] and Knowles pins [47]. …”

Section: Lateral End Fracturesmentioning

confidence: 99%

Fractures of the Clavicle: An Overview

Donnelly¹,

Macfarlane²,

Nagy³

et al. 2013

TOORTHJ

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Fractures of the clavicle are a common injury and most often occur in younger individuals. For the most part, they have been historically treated conservatively with acceptable results. However, over recent years, more and more research is showing that operative treatment may decrease the rates of fracture complications and increase functional outcomes. This article first describes the classification of clavicle fractures and then reviews the literature over the past decades to form a conclusion regarding the appropriate management.A thorough literature review was performed on assessment of fractures of the clavicle, their classification and the outcomes following conservative treatment. Further literature was gathered regarding the surgical treatment of these fractures, including the methods of fixation and the surgical approaches used. Both conservative and surgical treatments were then compared and contrasted.The majority of recent data suggests that operative treatment may be more appropriate as it improves functional outcome and reduces the risk of complications such as non-union. This is particularly evident in mid shaft fractures, although more high grade evidence is needed to fully recommend this, especially regarding certain fractures of the medial and lateral clavicle.

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“…Potential limitations include hardware migration or failure, re-fracture after hardware removal, painful prominent hardware, and the development of nonunion [ 13 ]. Since no consensus has been reached on the optimal treatment for mid-shaft CF, measuring the relative efficacies of different treatments procedures could help to improve the surgical outcomes and experiences of patients [ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Meta-analysis of differences in Constant-Murley scores for three mid-shaft clavicular fracture treatments

Jiang

Wang

et al. 2017

Oncotarget

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There is no consensus on the optimal treatment for mid-shaft clavicular fracture. We conducted a meta-analysis to compare the effectiveness of non-operative treatment, plate fixation, and intramedullary pin fixation in terms of the Constant-Murley Score (CMS) for treatment of mid-shaft clavicular fracture. Comprehensive search of the Embase, Cochrane Library and PubMed was conducted to retrieve relevant randomized controlled trials (RCTs). A random-effect network meta-analysis was conducted within a Bayesian framework using Markov Chain Monte Carlo (MCMC) in OpenBUGS 3.2.2. Differences in CMS among the three treatments analyzed were evaluated with weighted mean difference (WMD) and surface under the cumulative ranking curves (SUCRA). Eleven studies met our inclusion criteria and were included in our network meta-analysis. Our results revealed that in terms of CMS followed-up for six months, the efficacies of plate fixation and intramedullary pin fixation were higher than non-operative treatment (plate fixation: WMD = 4.70, 95% CI = 1.21 ∼ 7.83; intramedullary pin fixation: WMD = 6.71, 95% CI = 3.20 ∼ 10.39), and intramedullary pin fixation had better efficacy than plate fixation, had better efficacy. However, no differences were found between the efficacies of the three treatments in pairwise comparisons with respect to CMS followed-up for six weeks, three months, 12 months and 24 months. In addition, the cluster analysis showed that intramedullary pin fixation had the best efficacy for patients with mid-shaft CF, followed by plate fixation and non-operative treatment. These analyses suggest intramedullary pin fixation may be the optimal therapeutic approach for mid-shaft clavicular fracture patients.

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Comparing Hook Plates and Kirschner Tension Band Wiring for Unstable Lateral Clavicle Fractures

Cited by 27 publications

References 28 publications

Anatomical Locking Plate with Additional K-wire Fixation for Distal Clavicle Fracture

Anatomical Locking Plate with Additional K-wire Fixation for Distal Clavicle Fracture

Fractures of the Clavicle: An Overview

Meta-analysis of differences in Constant-Murley scores for three mid-shaft clavicular fracture treatments

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