The Efficacy Of Anatomic Locking Plate And Hook Plate In The Treatment Of Unstable Distal Clavicle Fractures

Objective: the purpose of this study was to evaluate the clinical and radiologic outcomes of unstable distal clavicle fractures treated with anatomic plate and hook plate.Methods: Between 2013.5 and 2016.1,forty patients with 40 unstable distal clavicle fractures who underwent open reduction and internal fixation at our institution with either a distal clavicular locking plate(13 patients)or a clavicular hook plate(27 patients)were evaluated.Treatment of 13 patients with distal clavicular anatomical locking plate.Male 11 people,female 2 people.8 cases on the left,5 cases on the right side.The average age was 43.46 ± 16.65 years(23-74 years).Fracture type: Neer ? A type 7 cases,Neer ? B type 6 cases.Cause of injury: 3 cases of car accident,8 cases of falls,2 cases of other reasons.Treatment of 27 patients with clavicular hook plate.Male 16 people,female 11 people.17 cases on the left,10 cases on the right side.The average age was 43.37 ± 16.18 years(19-74 years).Fracture type: Neer ? A type 17 cases,Neer ? B type 10 cases.Injury causes: 7 cases of car accidents,18 cases of falls,2 cases of other reasons.The main outcome comparisons included rate of union,rate of complication and the shoulder joint functional which evaluated using Constant and California-Los Angeles(UCLA)scores.Results:Bone union was achieved in all patients.Satisfactory clinical and radiologic outcomes were obtained.Between the patients who used locking plate(Constant score,90.2±2.7;UCLA score,31.8±2.2)and the patients who used hook plate(Constant score,87.8±4.9;UCLA score,30.7±2.8),there was no statistically significant difference in clinical outcomes of Constant score and UCLA score.However,the results indicated that the locking plate group had a lower rate of complications.Conclusion: Both distal clavicular locking plate and clavicular hook plate achieved good results in the treatment of unstable distal clavicle fractures;however,internal fixation with a distal clavicular locking plate had a lower rate of complications,patients who without additional coraclavicular ligament augmentation also achieved satisfactory shoulder functional outcomes.Therefore,anatomic locking plate can be considered the first of the treatment options for unstable distal clavicle fracture.