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Internal Fixation Using Clavicle Hook Plates for Distal Clavicle Fractures

  • Kim, Kwang-Yul (Department of Orthopedic Surgery, Wallace Memorial Baptist Hospital) ;
  • Kim, Hyung-Chun (Department of Orthopedic Surgery, Wallace Memorial Baptist Hospital) ;
  • Cho, Sung-Jun (Department of Orthopedic Surgery, Wallace Memorial Baptist Hospital) ;
  • Ahn, Su-Han (Department of Orthopedic Surgery, Wallace Memorial Baptist Hospital) ;
  • Kim, Dong-Seon (Department of Orthopedic Surgery, Wallace Memorial Baptist Hospital)
  • Received : 2014.08.06
  • Accepted : 2015.01.17
  • Published : 2015.03.30

Abstract

Background: To report the radiological and clinical outcomes of internal fixation using distal clavicle hook plates for distal clavicle fractures. Methods: From April 2008 to December 2012, 32 patients with distal clavicle fractures underwent surgery using an AO hook plate. The reduction was qualified and evaluated according to the radiological findings. The evaluation of the clinical outcomes was performed with the University of California at Los Angeles (UCLA) score, the Korean Shoulder score, and the visual analogue scale (VAS) pain score. Results: By radiological evaluation, we found that 31 of 32 patients showed anatomical reduction and solid bone union. Although we obtained satisfactory UCLA scores, Korean Shoulder Scale scores, and VAS pain scores, 12 cases of complications were present. We found 4 cases of osteolysis of the acromion, 1 case of nonunion, 3 cases of periprosthetic fractures, 3 cases of subacromial pain, and 1 case of skin irritation. We performed re-operations in 2 patients. Conclusions: To avoid complications associated with clavicle hook plates, choosing the appropriate hook size and bending of the hook according to the slope of the acromion undersurface is critical. Also, we believe that early removal of clavicle plates may help reduce complications.

Keywords

References

  1. NEER CS 2nd. Nonunion of the clavicle. J Am Med Assoc. 1960;172:1006-11. https://doi.org/10.1001/jama.1960.03020100014003
  2. Edwards DJ, Kavanagh TG, Flannery MC. Fractures of the distal clavicle: a case for fixation. Injury. 1992;23(1):44-6. https://doi.org/10.1016/0020-1383(92)90125-C
  3. Charity RM, Haidar SG, Ghosh S, Tillu AB. Fixation failure of the clavicular hook plate: a report of three cases. J Orthop Surg (Hong Kong). 2006;14(3):333-5. https://doi.org/10.1177/230949900601400320
  4. Levy O. Simple, minimally invasive surgical technique for treatment of type 2 fractures of the distal clavicle. J Shoulder Elbow Surg. 2003;12(1):24-8. https://doi.org/10.1067/mse.2003.128564
  5. Chen CH, Chen WJ, Shih CH. Surgical treatment for distal clavicle fracture with coracoclavicular ligament disruption. J Trauma. 2002;52(1):72-8. https://doi.org/10.1097/00005373-200201000-00013
  6. Mall JW, Jacobi CA, Philipp AW, Peter FJ. Surgical treatment of fractures of the distal clavicle with polydioxanone suture tension band wiring: an alternative osteosynthesis. J Orthop Sci. 2002;7(5):535-7. https://doi.org/10.1007/s007760200095
  7. Salem KH, Schmelz A. Treatment of Tossy III acromioclavicular joint injuries using hook plates and ligament suture. J Orthop Trauma. 2009;23(8):565-9. https://doi.org/10.1097/BOT.0b013e3181971b38
  8. Faraj AA, Ketzer B. The use of a hook-plate in the management of acromioclavicular injuries. Report of ten cases. Acta Orthop Belg. 2001;67(5):448-51.
  9. Habernek H, Weinstabl R, Schmid L, Fialka C. A crook plate for treatment of acromioclavicular joint separation: indication, technique, and results after one year. J Trauma. 1993;35(6):893-901. https://doi.org/10.1097/00005373-199312000-00016
  10. Goldberg JA, Bruce WJ, Sonnabend DH, Walsh WR. Type 2 fractures of the distal clavicle: a new surgical technique. J Shoulder Elbow Surg. 1997;6(4):380-2. https://doi.org/10.1016/S1058-2746(97)90006-9
  11. Kona J, Bosse MJ, Staeheli JW, Rosseau RL. Type II distal clavicle fractures: a retrospective review of surgical treatment. J Orthop Trauma. 1990;4(2):115-20. https://doi.org/10.1097/00005131-199004020-00002
  12. Craig EV. Fracture of the clavicle. In: Rockwood CA Jr, Green DP, Bucholz RW, Heckman JD, eds. Fracture in adult. 4th ed. Philadelphia: Lippincort-Raven; 1996. 1109-61.
  13. Kao FC, Chao EK, Chen CH, Yu SW, Chen CY, Yen CY. Treatment of distal clavicle fracture using Kirschner wires and tension-band wires. J Trauma. 2001;51(3):522-5. https://doi.org/10.1097/00005373-200109000-00016
  14. Mizue F, Shirai Y, Ito H. Surgical treatment of comminuted fractures of the distal clavicle using Wolter clavicular plates. J Nippon Med Sch. 2000;67(1):32-4. https://doi.org/10.1272/jnms.67.32
  15. Flinkkila T, Ristiniemi J, Lakovaara M, Hyvonen P, Leppilahti J. Hook-plate fixation of unstable lateral clavicle fractures: a report on 63 patients. Acta Orthop. 2006;77(4):644-9. https://doi.org/10.1080/17453670610012737
  16. Haidar SG, Krishnan KM, Deshmukh SC. Hook plate fixation for type II fractures of the lateral end of the clavicle. J Shoulder Elbow Surg. 2006;15(4):419-23. https://doi.org/10.1016/j.jse.2005.11.012
  17. Muramatsu K, Shigetomi M, Matsunaga T, Murata Y, Taguchi T. Use of the AO hook-plate for treatment of unstable fractures of the distal clavicle. Arch Orthop Trauma Surg. 2007;127(3):191-4. https://doi.org/10.1007/s00402-006-0284-5
  18. Renger RJ, Roukema GR, Reurings JC, Raams PM, Font J, Verleisdonk EJ. The clavicle hook plate for Neer type II lateral clavicle fractures. J Orthop Trauma. 2009;23(8):570-4. https://doi.org/10.1097/BOT.0b013e318193d878
  19. Meda PV, Machani B, Sinopidis C, Braithwaite I, Brownson P, Frostick SP. Clavicular hook plate for lateral end fractures:-a prospective study. Injury. 2006;37(3):277-83. https://doi.org/10.1016/j.injury.2005.10.017
  20. Bottlang M, Doornink J, Byrd GD, Fitzpatrick DC, Madey SM. A nonlocking end screw can decrease fracture risk caused by locked plating in the osteoporotic diaphysis. J Bone Joint Surg Am. 2009;91(3):620-7. https://doi.org/10.2106/JBJS.H.00408

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