Clavicular Hook Plate: A Better Implant Choice for Fixation of Unstable Distal Clavicle Fractures?

Tsai Hsueh Leu, Wei Pin Ho, Poo Kuang Wong, Tai Yuan Chuang, Chin Chean Wong

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: The ideal fixation method for unstable distal clavicle fractures is still controversial. Clavicular hook plates (HPs) are an effective option but the clinical efficacy and advantages/disadvantages of this implant compared with the tension band wire technique in treating this fracture have not been determined. Methods: A retrospective study was undertaken over a period of 3 years that included 45 patients, who were divided into two groups based on the treatment method. The clavicle HP group included 25 patients and the K-wire and tension band wire (KTBW) group included 20 patients. Radiographic examinations were taken to assess the adequacy of implant fixation and degree of bony union. Clinical results for pain, shoulder function and range of motion were evaluated using Constant-Murley scores. Results: Two groups of patients were similar in terms of age, sex, injury mechanisms, time to surgery, and time of follow-up. The results showed that the HP group had a significantly higher union rate and lower occurrence of surgical complications (p <0.001). However, 36% of patients in the HP group developed subacromial shoulder impingement syndrome before implant removal, and their functional scores were poorer than their nonimpinged counterparts. Conclusions: Although better surgical results and radiological outcome were achieved by using clavicle HP than KTBW in treating unstable distal clavicle fractures, the mechanical hook impingement imposed on the subacromial structures was remarkable and may have lowered the functional scores of patients receiving HP fixation. The result showed that clavicular HP did not offer more clinical advantages than with KTBW in treating unstable distal clavicle fracture.

Original languageEnglish
Pages (from-to)270-274
Number of pages5
JournalJournal of Experimental and Clinical Medicine(Taiwan)
Volume4
Issue number5
DOIs
Publication statusPublished - Oct 2012

Fingerprint

Clavicle
Shoulder Impingement Syndrome
Shoulder Pain
Articular Range of Motion
Retrospective Studies
Wounds and Injuries

Keywords

  • Clavicular hook plate
  • K-wire and tension band wire
  • Neer type II distal clavicle fractures

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{6bf86a9063424d41a045c73111d6463b,
title = "Clavicular Hook Plate: A Better Implant Choice for Fixation of Unstable Distal Clavicle Fractures?",
abstract = "Background: The ideal fixation method for unstable distal clavicle fractures is still controversial. Clavicular hook plates (HPs) are an effective option but the clinical efficacy and advantages/disadvantages of this implant compared with the tension band wire technique in treating this fracture have not been determined. Methods: A retrospective study was undertaken over a period of 3 years that included 45 patients, who were divided into two groups based on the treatment method. The clavicle HP group included 25 patients and the K-wire and tension band wire (KTBW) group included 20 patients. Radiographic examinations were taken to assess the adequacy of implant fixation and degree of bony union. Clinical results for pain, shoulder function and range of motion were evaluated using Constant-Murley scores. Results: Two groups of patients were similar in terms of age, sex, injury mechanisms, time to surgery, and time of follow-up. The results showed that the HP group had a significantly higher union rate and lower occurrence of surgical complications (p <0.001). However, 36{\%} of patients in the HP group developed subacromial shoulder impingement syndrome before implant removal, and their functional scores were poorer than their nonimpinged counterparts. Conclusions: Although better surgical results and radiological outcome were achieved by using clavicle HP than KTBW in treating unstable distal clavicle fractures, the mechanical hook impingement imposed on the subacromial structures was remarkable and may have lowered the functional scores of patients receiving HP fixation. The result showed that clavicular HP did not offer more clinical advantages than with KTBW in treating unstable distal clavicle fracture.",
keywords = "Clavicular hook plate, K-wire and tension band wire, Neer type II distal clavicle fractures",
author = "Leu, {Tsai Hsueh} and Ho, {Wei Pin} and Wong, {Poo Kuang} and Chuang, {Tai Yuan} and Wong, {Chin Chean}",
year = "2012",
month = "10",
doi = "10.1016/j.jecm.2012.09.002",
language = "English",
volume = "4",
pages = "270--274",
journal = "Journal of Experimental and Clinical Medicine",
issn = "1878-3317",
publisher = "Elsevier Taiwan LLC",
number = "5",

}

TY - JOUR

T1 - Clavicular Hook Plate

T2 - A Better Implant Choice for Fixation of Unstable Distal Clavicle Fractures?

AU - Leu, Tsai Hsueh

AU - Ho, Wei Pin

AU - Wong, Poo Kuang

AU - Chuang, Tai Yuan

AU - Wong, Chin Chean

PY - 2012/10

Y1 - 2012/10

N2 - Background: The ideal fixation method for unstable distal clavicle fractures is still controversial. Clavicular hook plates (HPs) are an effective option but the clinical efficacy and advantages/disadvantages of this implant compared with the tension band wire technique in treating this fracture have not been determined. Methods: A retrospective study was undertaken over a period of 3 years that included 45 patients, who were divided into two groups based on the treatment method. The clavicle HP group included 25 patients and the K-wire and tension band wire (KTBW) group included 20 patients. Radiographic examinations were taken to assess the adequacy of implant fixation and degree of bony union. Clinical results for pain, shoulder function and range of motion were evaluated using Constant-Murley scores. Results: Two groups of patients were similar in terms of age, sex, injury mechanisms, time to surgery, and time of follow-up. The results showed that the HP group had a significantly higher union rate and lower occurrence of surgical complications (p <0.001). However, 36% of patients in the HP group developed subacromial shoulder impingement syndrome before implant removal, and their functional scores were poorer than their nonimpinged counterparts. Conclusions: Although better surgical results and radiological outcome were achieved by using clavicle HP than KTBW in treating unstable distal clavicle fractures, the mechanical hook impingement imposed on the subacromial structures was remarkable and may have lowered the functional scores of patients receiving HP fixation. The result showed that clavicular HP did not offer more clinical advantages than with KTBW in treating unstable distal clavicle fracture.

AB - Background: The ideal fixation method for unstable distal clavicle fractures is still controversial. Clavicular hook plates (HPs) are an effective option but the clinical efficacy and advantages/disadvantages of this implant compared with the tension band wire technique in treating this fracture have not been determined. Methods: A retrospective study was undertaken over a period of 3 years that included 45 patients, who were divided into two groups based on the treatment method. The clavicle HP group included 25 patients and the K-wire and tension band wire (KTBW) group included 20 patients. Radiographic examinations were taken to assess the adequacy of implant fixation and degree of bony union. Clinical results for pain, shoulder function and range of motion were evaluated using Constant-Murley scores. Results: Two groups of patients were similar in terms of age, sex, injury mechanisms, time to surgery, and time of follow-up. The results showed that the HP group had a significantly higher union rate and lower occurrence of surgical complications (p <0.001). However, 36% of patients in the HP group developed subacromial shoulder impingement syndrome before implant removal, and their functional scores were poorer than their nonimpinged counterparts. Conclusions: Although better surgical results and radiological outcome were achieved by using clavicle HP than KTBW in treating unstable distal clavicle fractures, the mechanical hook impingement imposed on the subacromial structures was remarkable and may have lowered the functional scores of patients receiving HP fixation. The result showed that clavicular HP did not offer more clinical advantages than with KTBW in treating unstable distal clavicle fracture.

KW - Clavicular hook plate

KW - K-wire and tension band wire

KW - Neer type II distal clavicle fractures

UR - http://www.scopus.com/inward/record.url?scp=84869086483&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84869086483&partnerID=8YFLogxK

U2 - 10.1016/j.jecm.2012.09.002

DO - 10.1016/j.jecm.2012.09.002

M3 - Article

AN - SCOPUS:84869086483

VL - 4

SP - 270

EP - 274

JO - Journal of Experimental and Clinical Medicine

JF - Journal of Experimental and Clinical Medicine

SN - 1878-3317

IS - 5

ER -