Treatment of Distal Clavicle Fractures using a Scorpion Plate and Influence of Timing on Surgical Outcomes: A Retrospective Cohort Study of 105 Cases

Abstract

Background Plate fixation is the established method of treating unstable distal clavicle fractures. However, the appropriate timing of surgery for acute distal clavicle fractures remains unclear. The present study aimed to evaluate the clinical outcomes of osteosynthesis using a Scorpion plate and to assess the influence of surgery timing on the surgical outcomes for acute unstable distal clavicle fractures. Methods We retrospectively reviewed 105 patients who underwent fixation for acute unstable distal clavicle fractures (Neer type II and V) using the Scorpion plate between 2008 and 2018. Patients were divided into early (45 patients) and delayed (60 patients) treatment groups based on the timing of the surgical intervention (within or after seven days). The outcomes were postoperative complications (delayed union, peri-implant fracture, plate loosening, plate-related pain, and stiffness). We evaluated the outcomes from X-ray radiographs and clinical notes.Results Among the 105 patients, delayed union, plate loosening, plate-related pain, and stiffness were observed in six patients (5.7%), four patients (3.8%), seven patients (6.7%), and one (1.0%) patient, respectively. The delayed union rate was significantly higher in the delayed treatment group than that in the early treatment group (P=0.036). Although the difference was not significant, plate loosening and stiffness were only observed in the delayed treatment group. Conclusion Our results demonstrated that osteosynthesis using Scorpion plates achieved satisfactory surgical outcomes for unstable distal clavicle fractures . In addition, this study suggested that performing surgery within six days after injury is recommended to reduce postoperative complications .

Accelerated rehabilitation in treating neer type V distal clavicle fractures using anatomical locking plates with coracoclavicular ligament augmentation

“…The surgical treatment for unstable distal clavicle fractures yields higher union rates than conservative treatment [ 28 , 29 ]. Various surgical techniques have been developed, including hook or locking plates, Kirschner wires, CC screws, and suture tension band wiring.…”

Outcomes, Union Rate, and Complications After Operative and Nonoperative Treatments of Neer Type II Distal Clavicle Fractures: A Systematic Review and Meta-analysis of 2284 Patients

“…Another possible confounding factor was that in all except 1 study, the time between the occurrence of the fracture and the surgical intervention was not evaluated. Furuhata et al 18 divided their patients into treatment groups according to time to surgery. They observed no significant differences between the early and delayed surgery groups.…”