Orlandi Tino-Vito, Rogers Nicholas S, Burger Marilize C, King Paul R, Lamberts Robert P
Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa.
Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa; Division of Biokinetics, Department of Sport Science, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa.
J Shoulder Elbow Surg. 2022 May;31(5):906-913. doi: 10.1016/j.jse.2022.01.114. Epub 2022 Feb 11.
Two popular methods used to treat distal-third clavicle fractures are the traditional hook plate and the anatomically contoured locking plate. No consensus exists on whether one method is more effective than the other. Therefore, the aim of this study was to compare the efficacy of a traditional hook plate with that of an anatomically contoured locking plate augmented with coracoclavicular fixation in the treatment of distal-third clavicle fractures.
Enrolled patients were randomly assigned to either the hook plate group (n = 13) or the locking plate group (n = 17). Follow-up assessments (clinical and radiologic) were performed at 6 and 12 months postoperatively.
In both groups, union was achieved in 91% of cases at 6 months and 100% at 12 months. No differences in Disabilities of the Arm, Shoulder and Hand (DASH) and Constant-Murley shoulder scores were noted between the hook plate and locking plate groups at 12 months. From 6 to 12 months, DASH scores improved in the hook plate group (P = .007) and Constant-Murley shoulder scores tended to improve (P = .075). Surgical time was longer in the locking plate group than in the hook plate group (P < .001).
Similar functional outcomes and union rates were achieved in both groups at 12 months postoperatively. However, the improvement in DASH scores in the hook plate group from 6 to 12 months suggests that patients treated with an anatomically contoured locking plate make a quicker recovery than patients treated with a hook plate.
治疗锁骨远端三分之一骨折的两种常用方法是传统钩钢板和解剖型锁定钢板。对于哪种方法更有效尚无共识。因此，本研究的目的是比较传统钩钢板与解剖型锁定钢板联合喙锁固定治疗锁骨远端三分之一骨折的疗效。
将入选患者随机分为钩钢板组（n = 13）或锁定钢板组（n = 17）。术后6个月和12个月进行随访评估（临床和影像学）。
两组在术后6个月时91%的病例实现骨愈合，12个月时为100%。12个月时，钩钢板组和锁定钢板组在手臂、肩部和手部功能障碍（DASH）评分及Constant-Murley肩关节评分方面无差异。在6至12个月期间，钩钢板组的DASH评分有所改善（P = 0.007），Constant-Murley肩关节评分有改善趋势（P = 0.075）。锁定钢板组的手术时间比钩钢板组长（P < 0.001）。
两组术后12个月的功能结果和骨愈合率相似。然而，钩钢板组在6至12个月期间DASH评分的改善表明，与接受钩钢板治疗的患者相比，接受解剖型锁定钢板治疗的患者恢复更快。
