Clavicle hook plate fixation for distal-third clavicle fracture (Neer type II): comparison of clinical and radiologic outcomes between Neer types IIA and IIB

• Published in: Journal of shoulder and elbow surgery 2017-07, Vol.26 (7), p.1210-1215
• Main Authors: Lee, Wonyong, MD, Choi, Chong-Hyuk, MD, PhD, Choi, Yun-Rak, MD, PhD, Lim, Kyung-Han, MD, Chun, Yong-Min, MD, PhD
• Format: Article
• Language: English
• Subjects: Adult; Bone Plates; Clavicle - injuries; Clavicle - surgery; coracoclavicular distance; Distal clavicle fracture; Female; Fracture Fixation, Internal; Fractures, Bone - diagnostic imaging; Fractures, Bone - surgery; hook plate; Humans; Injury Severity Score; Male; Middle Aged; Neer type; Orthopedics; plate fixation; Range of Motion, Articular; Recovery of Function; Retrospective Studies; Treatment Outcome; unstable; Young Adult
• ISSN: 1058-2746; 1532-6500
• DOI: 10.1016/j.jse.2016.11.046

Background The purpose of this study was to investigate clinical and radiologic outcomes of clavicle hook plate fixation for distal-third clavicle fracture (Neer type II) and to compare the clinical and radiologic outcomes and complications between Neer type IIA and type IIB. Methods We retrospectively reviewed 35 patients who underwent open reduction and internal fixation with AO hook locking compression plate (LCP) for distal clavicle fracture, including 13 patients with Neer type IIA and 22 patients with type IIB. Visual analog scale pain score, shoulder scores (subjective shoulder value, University of California–Los Angeles shoulder score, American Shoulder and Elbow Surgeons score), and active range of motion were evaluated to determine clinical outcome. Coracoclavicular distance was measured, and that of the injured side at last follow-up was compared with that of the uninjured side to evaluate radiologic outcomes. Results AO hook LCP fixation for distal-third clavicle fracture (Neer type II) produced satisfactory radiologic outcomes, including high union rates (100%) and coracoclavicular distance maintenance, as well as satisfactory clinical outcomes, including visual analog scale score for pain, shoulder scores (subjective shoulder value, University of California–Los Angeles shoulder score, American Shoulder and Elbow Surgeons score), and active range of motion. There were no significant differences between Neer type IIA and type IIB. With regard to complications, 22.9% of patients experienced shoulder stiffness and 17.1% had subacromial erosion; however, there were no significant differences between the 2 groups. Conclusion The AO hook LCP is a suitable choice for Neer type IIA and type IIB distal-third clavicle fracture fixation.