A Comparative Study Of Two Surgical Methods In The Treatment Of Neer Type Ⅱ Distal Clavicle Fractures

Objective Comparison of the effect of titanium cable combined with distal clavicle plate fixation and the application of clavicle hook plate in the treatment of NeerⅡ type distal clavicle fractures is expected to provide a certain reference for the choice of treatment methods for NeerⅡ type distal clavicle fractures.Methods A collection of patients with NeerⅡ distal clavicle fractures admitted to the Department of Orthopedics from September 2018 to March 2020,cases were screened according to the inclusion and exclusion criteria,and a total of 30 cases of NeerⅡ fractures were obtained.According to the different methods of internal fixation,they were divided into two groups:the titanium cable group(fixed with a titanium cable in combination with a locking plate)and hook plate group(fixed with a clavicular hook plate only).Regular follow-up visits were performed to collect the preoperative coracoclavicular distance,operation time,intraoperative blood loss,fracture healing time,postoperative coracoclavicular distance,Constant-Murley score,the visual analog score,shoulder abduction angle,and complications.And make statistical analysis to compare the difference in curative effect of the two groups of surgical methods.Results 30 patients were followed up for 11-14 months,with an average of 12.12±0.8 months.Patients in both groups achieved clinical healing within 12 weeks after surgery.There was no statistical difference between the two groups in terms of hospitalization time,incision length,and postoperative coracoclavicular distance(P>0.05).The operation time and intraoperative blood loss of the hook plate group are less than those of the titanium cable group(P<0.05).In terms of the Constant-Murley score and the visual analog score in the first,third,and twelfth months after surgery,the titanium cable group was more dominant(P<0.05).There was a statistical difference between the preoperative and postoperative coracoclavicular distances within the group(P<0.05),but there was no statistical difference between the groups(P<0.05).In terms of complications,1 patient in the hook plate group suffered from subacromial osteolysis,and 3 patients suffered from long-term shoulder pain.Conclusion For the treatment of patients with NeerⅡ type distal clavicle fracture,titanium cable combined with distal clavicle plate is a better method.The internal fixation is reliable and the complications are fewer.It can more easily achieve the purpose of fracture healing and shoulder function recovery.