Department of Trauma Orthopaedics, The Adelaide and Meath Hospital, Dublin, Incorporating the National Children's Hospital, Dublin, Ireland.
J Shoulder Elbow Surg. 2012 Aug;21(8):1045-8. doi: 10.1016/j.jse.2011.07.020. Epub 2011 Oct 20.
Controversy exists with the use of the acromioclavicular hook plate for the treatment of lateral-third clavicle fractures (Neer type II). This is thought to stem from problems associated with the hook plate causing impingement symptoms, which can cause long-term limitation of movement and pain. Our aim was to evaluate the functional outcomes of patients with lateral-third clavicle fractures treated with the hook plate.
We prospectively reviewed all patients who underwent surgery from July 2005 to August 2009 using our prospectively recorded electronic patient information database. All patients were assessed in the clinic to determine both Oxford and Constant shoulder scores.
We identified 36 patients who underwent surgery with the hook plate, 26 men and 10 women. The mean age was 36.2 years (range, 22-60 years). Of the patients, 46% were smokers. The median length of hospital stay was 2 days (interquartile range [IQR], 1-3). The median follow-up was 28 months (IQR, 23-37). The median time from date of injury to surgery was 7 days (IQR, 4-76). The mean time to union was 3 months (IQR, 2-4), and the union rate was 95%. In total, 92% of plates were removed. The median time to removal was 4.5 months (IQR, 3-8.75). There were no complications. Two patients presented months later after falls with fractures around the medial end of the hook plate.
Hook plates are an effective form of treatment for lateral third clavicle fractures. The best outcomes occur with plate removal before 6 months postoperatively, provided that the fracture has healed.
对于治疗锁骨外侧三分之一骨折（Neer 型 II 型），使用肩锁钩板存在争议。这被认为源于钩板引起的撞击症状相关问题，这可能导致长期运动受限和疼痛。我们的目的是评估使用钩板治疗锁骨外侧三分之一骨折患者的功能结果。
我们前瞻性地回顾了 2005 年 7 月至 2009 年 8 月期间使用我们前瞻性记录的电子患者信息数据库进行手术的所有患者。所有患者均在诊所进行评估，以确定牛津和常数肩部评分。
我们确定了 36 名接受钩板手术的患者，其中 26 名男性和 10 名女性。平均年龄为 36.2 岁（范围 22-60 岁）。患者中有 46%为吸烟者。住院中位数为 2 天（四分位距 [IQR]，1-3）。中位数随访时间为 28 个月（IQR，23-37）。从受伤日期到手术的中位数时间为 7 天（IQR，4-76）。平均愈合时间为 3 个月（IQR，2-4），愈合率为 95%。总共 92%的板被移除。移除的中位数时间为 4.5 个月（IQR，3-8.75）。没有并发症。两名患者在跌倒后数月出现钩板内侧端周围骨折。
钩板是治疗锁骨外侧三分之一骨折的有效方法。如果骨折已经愈合，在术后 6 个月之前取出板，结果最佳。
