ABSTRACT
BACKGROUND: Until now there have been no prospective studies describing the results of using the superior clavicle plate with lateral extension in patients with displaced lateral clavicle fractures (Neer type 2). The purpose of this study was to evaluate the results of applying this plate for this specific type of fracture. MATERIALS AND METHODS: In this prospective study, seven patients (mean age 43, M:F; 6:1) with a fresh displaced lateral clavicle fracture were evaluated with a mean follow-up of 10 months. Analysis included functional and subjective outcome, time until union, time until return to work, and complications. RESULTS: All patients achieved clinical and radiological union within 6-12 weeks. Full range of motion as well as a return to work was achieved in most cases within 2 weeks. The mean Constant score was 98 (range 90-100), the DASH score was 3.6 (range 0-11.4), and the Shoulder Rating Questionnaire score was 97 (range 96-100). No major complications were encountered. Three patients required plate removal: two because of a prominent and subcutaneous plate and one because of an intra-articular screw. CONCLUSIONS: In this study, use of the superior clavicle plate with lateral extension yielded excellent results in the treatment of this difficult fracture. In particular, patients acquired full range of motion within 2 weeks, reflecting the stability of the osteosynthesis achieved with this implant.
Subject(s)
Bone Plates , Clavicle/injuries , Fracture Fixation, Internal/instrumentation , Adult , Equipment Design , Female , Humans , Male , Prospective StudiesABSTRACT
BACKGROUND: The clavicle hook plate achieves like most other operative techniques, a high percentage of union and a low percentage of complications however concerns about long term complications still exist, particularly the involvement of the acromioclavicular joint. METHODS: To evaluate the results and long term effects in use of this plate we performed a retrospective analysis with a mean follow up of 65 months (5.4 years) of 28 consecutive patients with acute displaced lateral clavicle fractures, treated with the clavicle hook plate. RESULTS: Short term functional results in all patients were good to excellent. All but one patient had a united fracture (96%). Nine patients (32%) developed impingement symptoms and in 7 patients (25%) subacromial osteolysis was found. These findings resolved after plate removal. Twenty-four patients were re-evaluated at a mean follow-up period of 5.4 years. The Constant-Murley score was 97 and the DASH score was 3.5. Four patients (14%) developed acromioclavicular joint arthrosis of which one was symptomatic. Three patients (11%) had extra articular ossifications of which one was symptomatic. There was no relation between the impingement symptoms, subacromial osteolysis and development of acromioclavicular joint arthrosis or extra articular ossifications. CONCLUSIONS: The clavicle hook plate is a good primary treatment option for the acute displaced lateral clavicle fracture with few complications. At mid term the results are excellent and no long term complications can be addressed to the use of the plate.
