Department of Orthopaedic Surgery, Ashikaga Red Cross Hospital, 284-1 Yobe-cho, Ashikaga-shi, 326-0843, Tochigi, Japan.
Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
BMC Musculoskelet Disord. 2024 Nov 14;25(1):909. doi: 10.1186/s12891-024-08039-z.
Neer type V distal clavicle fractures are considered the most unstable fracture type and are characterized by the disruption of continuity between the coracoclavicular (C-C) ligaments and proximal or distal bone fragments. However, owing to the rarity of such fractures, there is currently no universally accepted surgical procedure for their treatment. Recently, the scorpion plate, an anatomical, non-locking, pre-contoured plate with two grasping arms to fix the distal or inferior clavicular fragments, was introduced. This study aimed to investigate the postoperative functional and radiological outcomes of osteosynthesis using only scorpion plates in Neer type V fractures.
We retrospectively identified 23 patients who underwent scorpion plate fixation for Neer type V fractures at two general hospitals. All patients underwent only plate fixation without C-C ligament augmentation. Subsequently, we investigated their postoperative functional outcomes, complication rates, and modified C-C distance ratio at 1 year.
The mean postoperative Constant score was 96 ± 5, with all cases achieving bone union. Complications within 1 year postoperatively included plate loosening in one patient (4.3%) and plate irritation in two patients (8.7%). Additionally, the modified C-C distance ratio averaged 114 ± 15%.
This study offers novel insights into the management of Neer type V distal clavicle fractures. Our findings indicate that osteosynthesis using only scorpion plates can lead to satisfactory functional outcomes with minimal complications.
Neer 型 V 型锁骨远端骨折被认为是最不稳定的骨折类型，其特征是喙锁（CC）韧带和锁骨近端或远端骨碎片之间连续性中断。然而，由于此类骨折较为罕见，目前尚无普遍接受的治疗此类骨折的手术方法。最近，引入了一种解剖学、非锁定、预弯曲的带有两个抓握臂的蝎子钢板，用于固定锁骨远端或下锁骨碎片。本研究旨在探讨仅使用蝎子钢板治疗 Neer 型 V 型骨折的术后功能和影像学结果。
我们回顾性地确定了在两家综合医院接受蝎子钢板固定 Neer 型 V 型骨折的 23 名患者。所有患者均仅行钢板固定，未行 CC 韧带增强。随后，我们调查了他们在术后 1 年的功能结果、并发症发生率和改良 CC 距离比。
术后平均 Constant 评分 96±5，所有病例均达到骨性愈合。术后 1 年内的并发症包括 1 例（4.3%）钢板松动和 2 例（8.7%）钢板刺激。此外，改良 CC 距离比平均为 114±15%。
本研究为 Neer 型 V 型锁骨远端骨折的治疗提供了新的见解。我们的研究结果表明，仅使用蝎子钢板进行内固定可以获得满意的功能结果，且并发症较少。
