The Radiologic Comparison of Operative Treatment Using a Hook Plate versus a Distal Clavicle Locking Plate of Distal Clavicle Fracture

Abstract

BACKGROUND: The purpose of this study was to compare the radiologic results of patients who underwent surgery with a hook plate and a locking plate in distal clavicle fractures.METHODS: Sixty patients underwent surgical treatment for Neer type IIa, IIb, III, and V distal clavicle fracture. Twenty-eight patients underwent fracture fixation with a hook plate and 32 with a locking plate. Coracoclavicular distance was measured on standard anteroposterior radiographs before and after the surgery, and union was confirmed by radiograph or computed tomography taken at 6 months postoperatively. Other radiologic complications like osteolysis was also checked.RESULTS: Bony union was confirmed in 59 patients out of 60 patients, and 1 patient in the hook plate group showed delayed union. Coracoclavicular distance was decreased more in the hook plate group after surgery (p < 0.01). After 6 weeks of the hook plate removal, the coracoclavicular distance was increased a little compared to before metal removal, but there was no difference compared to the contralateral shoulder. Eleven out of 28 patients (39.3%) showed osteolysis on the acromial undersurface in the hook plate group.CONCLUSIONS: Both the hook plate group and the locking plate group showed satisfactory radiologic results in distal clavicle fractures. Both hook plate and locking plate could be a good treatment option if it is used in proper indication in distal clavicle fracture with acromioclavicular subluxation or dislocation.

Comparison of Locking Plate Osteosynthesis versus Coracoclavicular Stabilization for Neer Type IIB Lateral Clavicle Fractures

“…A few studies reported that hook plate fixation for type IIB fractures resulted in satisfactory clinical outcomes after surgery, if the lateral fragment is too small for insertion of screws. 4 17 21 22) However, hook plate fixation has a high complication rate of acromial osteolysis or fracture, hook cutting-out, subacromial impingement, and rotator cuff tears. 4 9 23) In addition, there is a drawback regarding the requirement for implant removal within 6 months after surgery.…”

“… 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20) Several studies reported that hook plate fixation can be a useful surgical option for achievement of satisfactory clinical results, if the lateral fragment is too small for insertion of screws. 4 17 21 22) However, a high complication rate has been reported for hook plate fixation and there is a drawback regarding the need for implant removal within 6 months after surgery. 4 9 23) Several authors advocated that PLPO can be a reliable surgical option for treatment of type IIB fractures because it facilitates better stability of the small lateral fragment by multi-planar locking screw fixation.…”

“…To date, several comparative studies between these surgical techniques for the treatment of unstable lateral clavicle fractures have been reported. 9 17 21 22 23 27) However, no comparative study between PLPO and CCS using a suture button device for type IIB fractures has been reported. The purpose of this study was to compare outcomes and complications between PLPO and CCS using a TightRope (Arthrex, Naples, FL, USA) for type IIB fractures.…”

Travmatik Tip III Akromiyoklaviküler Eklem Çıkığı Tedavisinde Kanca Plak ile Tespit İdeal Bir Tedavi Yöntemi Midir?

“…Kancalı plak ile akromiyoklaviküler eklem cerrahisi sonrası postoperatif osteoliz %30,3, %39,3, %50 olarak bildirilmiştir. [15][16][17] Hastalarımızın postoperatif subakromiyal osteoliz sonucu %38,8'ini bulduk, bu sonuç literatürle uyumludur. Literatüre göre; subakromiyal osteoliz omuz fonksiyonunu önemli ölçüde etkilemez.…”

Biomechanical Analysis of Clavicle Hook Plates with a Range of Posterior Hook Offsets Implanted at Different Acromion Positions in the Acromioclavicular Joint: A Finite Element Analysis Study

“…A clavicle hook plate is widely used to treat acromioclavicular dislocation and distal clavicle fracture [1][2][3][4][5][6], as its unique hook shape can provide a good stability and partial rotational mobility of the acromioclavicular joint [7]. Although it is a convenient, simple, and effective treatment [5,6], some complications still occur, such as subacromial osteolysis [8][9][10], rotator cuff impingement [11], rotator cuff tear [11], and peri-implant fracture [10,[12][13][14][15]. Furthermore, there is much variation in the anatomy of the acromion between individuals [16][17][18][19].…”