Department of Orthopaedics, Changzheng Hospital, Second Military Medical University, 415# Fengyang Road, Huangpu District,, 200003, Shanghai, China.
BMC Musculoskelet Disord. 2021 Mar 12;22(1):269. doi: 10.1186/s12891-021-04137-4.
There is controversy about the optimal strategy treatment of unstable distal clavicle fractures. We explored use of a surgical strategy: combination of a distal clavicle locking plate and a titanium cable. The purpose of this retrospective case series study was to evaluate the clinical outcomes of this new strategy in treating Neer type II distal clavicle fractures.
Twenty-one patients with Neer type II distal clavicle fracture were treated with a distal clavicle locking plate and a titanium cable. All patients were followed for at least one year. We retrospectively collected and reviewed follow-up data. The clinical outcomes were assessed for union rate, functional score, and complication rate.
All patients achieved bony union within 6 months. The average follow-up period was 20.6 months (range12-48 months). The mean Constant score at one-year follow-up was 94.6 ± 3.3 (range 84-98), and the mean UCLA (University of California, Los Angeles) score was 33.3 ± 2.6 (range 27-35). Only one complication (wound infection) was observed during follow-up. Two patients received another operation for implant removal due to local irritation.
Use of a distal clavicle locking plate in combination with a titanium cable for treatment of Neer type II fractures results in high union rate, a low complication rate, and good shoulder function. This combined surgical strategy can be considered an effective method for treating unstable distal clavicle fractures.
不稳定型锁骨远端骨折的治疗策略存在争议。我们探索了一种手术策略：锁骨远端锁定板和钛缆的联合应用。本回顾性病例系列研究的目的是评估这种新策略治疗 Neer Ⅱ型锁骨远端骨折的临床疗效。
采用锁骨远端锁定板和钛缆治疗 21 例 Neer Ⅱ型锁骨远端骨折患者。所有患者均随访至少 1 年。我们回顾性地收集和分析了随访资料。评估了愈合率、功能评分和并发症发生率等临床疗效。
所有患者均在 6 个月内达到骨性愈合。平均随访时间为 20.6 个月（范围 12-48 个月）。术后 1 年的Constant 评分平均为 94.6±3.3（范围 84-98），UCLA 评分平均为 33.3±2.6（范围 27-35）。随访期间仅观察到 1 例并发症（伤口感染）。因局部刺激，有 2 例患者接受了另一次手术以取出植入物。
锁骨远端锁定板联合钛缆治疗 Neer Ⅱ型骨折可获得较高的愈合率、较低的并发症发生率和良好的肩部功能。这种联合手术策略可被视为治疗不稳定型锁骨远端骨折的有效方法。
