Department of Orthopaedic Surgery, Stanford University, 450 Broadway Street, Pavilion C, 4th Floor, Redwood City, CA, 94063-6342, USA.
Eur J Orthop Surg Traumatol. 2020 Aug;30(6):1027-1031. doi: 10.1007/s00590-020-02658-7. Epub 2020 Mar 27.
This study examined the outcomes and complications after treatment of unstable distal clavicle fractures with hook or locking plate fixation.
A retrospective search was performed of all acute distal clavicle fractures treated with open reduction and internal fixation from 2009 to 2019 at a Level I trauma center. Patients were separated into hook and locking plate fixation groups. Rates of union, complications, and reoperation, were extracted. QuickDASH (Disabilities of Arm, Shoulder, and Hand) scores were determined.
Thirty-one patients met the inclusion criteria and were included in the study. Of these, 12 patients were treated with hook plates and 19 were treated with locking plates. All fractures healed without loss of reduction, regardless of implant selection. There were no immediate or long-term complications in either group. 83% of hook plate patients underwent planned implant removal, while 37% of locking plate patients requested implant removal secondary to irritation. QuickDASH scores were comparable and excellent in both groups.
Hook and locking plate fixation for Neer type-II and type-V distal clavicle fractures have comparably high rates of union. Hook plates were removed routinely per protocol, while locking plates were removed only if symptomatic and occurred significantly less often.
本研究探讨了钩钢板或锁定钢板固定治疗不稳定型锁骨远端骨折的疗效和并发症。
回顾性检索了 2009 年至 2019 年在一家一级创伤中心接受切开复位内固定治疗的急性锁骨远端骨折患者。患者分为钩钢板和锁定钢板固定组。提取了愈合率、并发症和再次手术率。测定了 QuickDASH（手臂、肩部和手部残疾）评分。
31 例患者符合纳入标准，纳入本研究。其中 12 例患者采用钩钢板治疗，19 例患者采用锁定钢板治疗。所有骨折均愈合，无论选择何种植入物，均无复位丢失。两组均无即刻或长期并发症。83%的钩钢板患者行计划性植入物取出，而 37%的锁定钢板患者因刺激要求取出植入物。两组 QuickDASH 评分均相似且优良。
Neer Ⅱ型和Ⅴ型锁骨远端骨折的钩钢板和锁定钢板固定具有较高的愈合率。钩钢板根据方案常规取出，而锁定钢板仅在有症状时取出，且发生率明显较低。
