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Abstract
Purpose
To compare the clinical and radiological outcomes of two surgical methods with tension band wire and Hook plate for unstable distal clavicle fractures.
Materials and Methods
Thirty patients with type II distal clavicle fractures were evaluated, who were operated with tension band wire (Group I) and Hook plate (Group II) fixation, from June 2005 to June 2009, and could be followed-up for more than 1 year after operation. The reduction and union were evaluated by the immediate post-operative and final radiographs. The functional outcome was evaluated by Kona's system and Constant-Murley scoring system.
Results
All 30 cases showed bony union. By Kona's functional evaluation, there were 16 cases with excellent and good results in Group I and 14 cases in Group II. The average Constant score was 88.3 (71~100) in Group I and 89.6 (72~100) in Group II, but there was no significant difference in both groups. As complications, there were 2 case with subacromial impingement, and 1 case showed subacromial erosion. There was no K-wire migration, deep infection and acromioclavicular joint arthritis.
Conclusion
Tension band and Hook plate fixation technique gave satisfactory clinical and radiological results in patients with type II distal clavicle fractures. These results suggest that tension band wire and Hook plate fixation technique seems to be an effective method for type II distal clavicle fracture. But we think thal early removal of plate is necessary due to risks for subacromial impingement and erosion in Hook plate fixation.
Figures and Tables
Fig. 1
(A) Radiograph of 56-year-old male shows Neer type II distal clavicle fracture.
(B) Satisfactory reduction and tension band wire fixation without acromioclavicular joint injury were seen in immediate postoperative radiograph.
(C, D) Bony union was seen in postperative 6 months radiograph and there were no K-wire migration and acromioclavicular joint arthritis.
Fig. 2
(A) Radiograph of 57-year-old male shows Neer type II distal clavicle fracture.
(B) Satisfactory reduction and Hook plate fixation were seen in immediate postoperative radiograph.
(C) Proximal screw loosening & plate migration were seen in postperative 6 months radiograph and there was subacromial impingment symptom.
(D) After the operation of Hook plate removal, radiographs show good bony union and impingment symptom was disappeared.
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