Comparison of Locking Compression Plate Superior Anterior Clavicle Plate with Suture Augmentation and Hook Plate for Treatment of Distal Clavicle Fractures

Jun-Cheol Choi; Woo-Suk Song; Woo-Sung Kim; Jeong-Muk Kim; Chan-Woong Byun

doi:10.12790/ahm.2017.22.4.247

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Choi, Song, Kim, Kim, and Byun: Comparison of Locking Compression Plate Superior Anterior Clavicle Plate with Suture Augmentation and Hook Plate for Treatment of Distal Clavicle Fractures

Original Article

Archives of Hand and Microsurgery 2017; 22(4): 247-255.

Published online: 31 December 2017

DOI: https://doi.org/10.12790/ahm.2017.22.4.247

Comparison of Locking Compression Plate Superior Anterior Clavicle Plate with Suture Augmentation and Hook Plate for Treatment of Distal Clavicle Fractures

Jun-Cheol Choi¹, Woo-Suk Song¹, Woo-Sung Kim², Jeong-Muk Kim¹, Chan-Woong Byun¹

¹Department of Orthopedic Surgery, Bundang Jesaeng Hospital, Daejin Medical Center, Seongnam, Korea.

²Department of Orthopedic Surgery, Hyundae Hospital, Namyangju, Korea.

Corresponding author: Woo-Suk Song. Department of Orthopedic Surgery, Bundang Jesaeng Hospital, Daejin Medical Center, 20 Seohyeon-ro 180beon-gil, Bundang-gu, Seongnam 13590, Korea. TEL: +82-31-779-0175, FAX: +82-31-779-0176, oskjmuk@gmail.com

Received 31 August 2017 Revised 22 October 2017 Accepted 23 October 2017

Korean Society for Surgery of the Hand, Korean Society for Microsurgery

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to compare the results (or effectiveness) of anterior superior locking compression plate (LCP) with suture augmentation and hook plate in treatment of Neer type II distal clavicle fracture.

Methods

From April 2009 to October 2015, 34 patients with distal clavicle fracture of Neer type II were surgically treated. Eleven patients were operated with LCP-suture augmentation (group I) and 23 patients underwent by hook plate (group II). Radiographic evaluation and functional evaluation using Korean Shoulder Society (KSS) scoring system were performed.

Results

Radiographic unions were achieved in all cases and mean radiographic union period was not different either as 4.1 months (range 3-14 months), 5.0 months (range 3-14 months) in group I and 3.7 months (range 3-11 months) in group II. However, KSS score was 87.6 (range 82-92) in group I, and was 63.4 (range 32-86) in group II (p<0.05). One case of osteolysis and no case of frozen shoulder were found in group I while 6 cases of osteolysis and 3 cases of frozen shoulder were found in group II.

Conclusion

LCP-suture augmentation is considered a more effective method, compared to hook plate osteosynthesis for distal clavicle fracture of Neer type II, producing better clinical outcomes and lower incidence of complications.

Keywords: Clavicle, Distal clavicle fracture, Locking compression plate superior anterior clavicle plate, Hook plate

Figures and Tables

Fig. 1

(A) Intraoperative photograph of the left shoulder of a 38-year-old male shows left distal clavicle fracture. After the exposure of fracture fragment, displacement of major fragment is observed. (B) An additional mersilene tape is applied to fix plate and bony fragments with reduction. (C) Reduction is identified by intraoperative C-arm intensifier (D) The fracture is reducted and fixated with a plate, screw and additional 2 mersilene tapes and an Ethibond binding.

Fig. 2

(A) Preoperative radiograph of the left shoulder of a 38-year-old male shows left distal clavicle fracture. (B) This is postoperative radiograph with locking compression plate superior clavicle plate. (C) At 3 months follow-up, bony union is achieved.

Fig. 3

(A) Postoperative radiograph of the left shoulder of a 35-year-old male shows right distal clavicle fracture. (B) At 6 months follow-up, the radiograph shows osteolysis of acromion by the Hook plate. (C) At 8 months follow-up, Hook plate was removed.

Table 1

Demographic data

Values are presented as median (range) or number only.

Group I: operated with locking compression plate-suture augmentation, Group II: underwent by hook plate.

^*By Pearson chi-square test. ^†Classification of Craig.9.

Table 2

Comparison of clinical outcome between two group

Values are presented as median (range).

Group I: operated with LCP-suture augmentation, Group II: underwent by hook plate, KSS: Korean Shoulder Society.

^*By independent t-test.

Table 3

Summary of complication

Group I: operated with LCP-suture augmentation, Group II: underwent by hook plate, KSS: Korean Shoulder Society.

^*Classification of Craig9.

Notes

^{CONFLICTS OF INTEREST} The authors have nothing to disclose.

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