School of Clinical Medicine, Tsinghua University, Beijing, China (mainland).
Department of Orthopedics Traumatology, Beijing Jishuitan Hospital, Beijing, China (mainland).
Med Sci Monit. 2017 Nov 16;23:5455-5461. doi: 10.12659/msm.903440.
BACKGROUND Surgical managements were recommended for unstable distal clavicle fracture owing to the high incidence of nonunion. The present study compared the efficacy of anatomical locking plate with versus without additional suture anchor fixation for the treatment of unstable Neer type II distal clavicle fractures. MATERIAL AND METHODS Between January 2013 to January 2015, 28 consecutive patients with unstable Neer type II fractures were treated by using anatomical locking plate with or without additional suture anchor fixation. The patients were divided into anatomical locking plate group (group A) and anatomical locking plate combined with suture anchor group (group B) according to the surgical method. The operative-related parameters such as operation time, blood loss, length of hospitalization, union time, functional outcomes (Constant score, UCLA score and DASH score) and CC distance were compared. RESULTS The mean follow-up period of the 28 patients was 19.60 months (21.80 versus 18.39 months, respectively). No statistical differences in general and peri-operative parameters were found between 2 groups. The group B had significant higher Constant score than group A (P=0.004, 91.67 versus 83.10). While no statistical differences were reached in the UCLA score and DASH score between 2 groups (P=0.112 and 0.163, respectively). The group A had longer CC distance than group B (11.67 versus 8.94 mm), while no statistic difference was found (P=0.067). CONCLUSIONS For the treatment of acute unstable Neer type II distal clavicle fractures, both surgical methods could offer satisfactory outcome. However, anatomical locking plate combined with additional suture anchor fixation had a better functional and radiographic outcome than that without additional suture anchor fixation.
由于不愈合发生率高，不稳定型锁骨远端骨折推荐手术治疗。本研究比较了解剖锁定钢板加与不加附加缝线锚定固定治疗不稳定型 Neer II 型锁骨远端骨折的疗效。
2013 年 1 月至 2015 年 1 月，连续 28 例不稳定型 Neer II 型骨折患者采用解剖锁定钢板加或不加附加缝线锚定固定治疗。根据手术方法，将患者分为解剖锁定钢板组（A 组）和解剖锁定钢板联合缝线锚定组（B 组）。比较两组手术相关参数，如手术时间、失血量、住院时间、愈合时间、功能结果（Constant 评分、UCLA 评分和 DASH 评分）和 CC 距离。
28 例患者平均随访 19.60 个月（分别为 21.80 个月和 18.39 个月）。两组一般及围手术期参数无统计学差异。B 组Constant 评分明显高于 A 组（P=0.004，91.67 比 83.10）。两组 UCLA 评分和 DASH 评分无统计学差异（P=0.112 和 0.163）。A 组 CC 距离大于 B 组（11.67 比 8.94mm），但差异无统计学意义（P=0.067）。
对于急性不稳定型 Neer II 型锁骨远端骨折，两种手术方法均可获得满意的结果。然而，与不加附加缝线锚定固定相比，解剖锁定钢板加附加缝线锚定固定在功能和影像学结果方面更好。
