Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
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Hook Plate Fixation for Unstable Distal Clavicle Fractures: A Prospective Study

불안정 원위 쇄골 골절의 치료에서 Hook 금속판을 이용한 전향적 연구

  • Kim, Kyung-Cheon (Department of Orthopedic Surgery, Chungnam National University School of Medicine) ;
  • Shin, Hyun-Dae (Department of Orthopedic Surgery, Chungnam National University School of Medicine) ;
  • Cha, Soo-Min (Department of Orthopedic Surgery, Chungnam National University School of Medicine) ;
  • Jeon, Yoo-Sun (Department of Orthopedic Surgery, Chungnam National University School of Medicine)
  • 김경천 (충남대학교 의학전문대학원 정형외과학교실) ;
  • 신현대 (충남대학교 의학전문대학원 정형외과학교실) ;
  • 차수민 (충남대학교 의학전문대학원 정형외과학교실) ;
  • 전유선 (충남대학교 의학전문대학원 정형외과학교실)
  • Received : 2011.04.28
  • Accepted : 2011.05.23
  • Published : 2011.06.30
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Abstract

Purpose: We wanted to analyze and report on the radiologic and clinical results of prospective Hook plate fixation for unstable distal clavicle fractures after a minimum of 2 years follow up. Materials and Methods: We followed up 17 out of 20 cases that underwent prospective Hook plate fixation from 2008 to 2009. We performed radiologic follow up at 2 weeks, 6 weeks, 3 months, 6 months, 18 months and 24 months postoperatively. The clinical results were evaluated at 12 months and 24 months postoperatively. Results: The mean period for bony fusion was 14.5 weeks and the plate was removed after an average of 20.2 weeks. The VAS pain scores were 0.7 and 0.8, the UCLA scores were 33.5 and 33.3, the ASES scores were 92.8 and 92.5, the Constant-Murley scores were 81.5 and 77.0, the KSS scores were 92.5 and 94.3 and the ranges of motion were $173.3^{\circ}$ and $173.7^{\circ}$ of flexion, $56.0^{\circ}$ and $54.5^{\circ}$ of external rotation, $62.3^{\circ}$ and $63.5^{\circ}$ of the internal rotation, $172.0^{\circ}$ and $172.6^{\circ}$ of abduction and $43.3^{\circ}$, and $42.9^{\circ}$ of extension at 1 and 2 years follow-up, respectively. There was no statistically significant difference of clinical outcomes and the range of motion at 1 year and 2 year postoperatively (p>0.05). There was no other complication except 1 case of delayed union. Conclusion: For Hook plate fixation at 2 years postoperatively, the complications will be decreased and excellent clinical results should occur.

목적: 불안정 원위 골절에 대해 전향적으로 잠김 압박 Hook 금속판을 사용하여 최소 2년의 추시를 통해 방사선학적 및 임상적 결과를 분석하고 그 결과를 보고하고자 한다. 대상 및 방법: 2008년부터 2009년까지 전향적으로 Hook 금속판 고정술을 시행받은 20예 중 17예를 추시하였다. 술 후 2주, 6주, 3개월, 6개월, 12개월, 18개월, 24개월에 방사선학적 추시를 하였고, 임상적 결과는 술 후 12개월, 24개월에 평가하였다. 결과: 평균 골 유합기간은 14.5주, 금속판 제거 시기는 20.2주였다. 1년 및 2년 추시상 평균 VAS 통증 점수는 0.7, 0.8, UCLA 점수는 33.5, 33.3, ASES 점수는 92.8, 92.5, Constant-Murley 점수는 81.5, 77.0, KSS 점수는 92.5, 94.3, 견관절 운동 범위는 굴곡 $173.3^{\circ}$, $173.7^{\circ}$, 외회전 $56.0^{\circ}$, $54.5^{\circ}$ 내회전 $62.3^{\circ}$, $63.5^{\circ}$, 외전 $172.0^{\circ}$, $172.6^{\circ}$, 신전 $43.3^{\circ}$, $42.9^{\circ}$였다. 임상적 결과 및 관절 운동 범위 모두 1년 및 2년 추시상 통계학적 의미있는 차이는 없었다 (p>0.05). 1예의 지연 유합 이외에는 다른 합병증은 없었다. 결론: Hook 금속판을 이용하여 내고정 후 2년 추시 상 우수한 임상 결과를 얻을 수 있었다.

Keywords

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  1. Surgical Treatment of Unstable Distal Clavicle Fractures: Comparison of Transacromial Pin Fixation and Hook Plate Fixation vol.16, pp.2, 2013, https://doi.org/10.5397/CiSE.2013.16.2.123
  2. In vivo analysis of acromioclavicular joint motion after hook plate fixation using three-dimensional computed tomography vol.24, pp.7, 2015, https://doi.org/10.1016/j.jse.2014.12.012