Clavicle hook plate versus distal clavicle locking plate for Neer type II distal clavicle fractures

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(2019) 14:472

RESEARCH ARTICLE

Open Access

Clavicle hook plate versus distal clavicle locking plate for Neer type II distal clavicle fractures Liang Li†, Tian-yan Li†, Peichao Jiang, Guizhen Lin*, Hongxiao Wu, Xiaochuan Han and Xuezhong Yu

Abstract Background: The purpose of this meta-analysis was to compare clavicle hook plates versus distal clavicle locking plates for the treatment of Neer type II distal clavicle fractures. Methods: PubMed (1996 to January 2019), Embase (1980 to January 2019), Web of Science (1990 to January 2019), the Cochrane Library (January 2019), and the China National Knowledge Infrastructure (January 2019) were systematically searched without language restrictions for literature retrieval. The Constant-Murley shoulder joint function score at 3 and 6 months after the operation and the postoperative complications after the operation (shoulder joint pain, abduction restriction, fracture delay healing, subacromial impingement) were the outcomes. Stata 12.0 was used for the meta-analysis. Results: A total of 9 clinical trials involving 446 patients were finally included in this meta-analysis. The results showed that the improvement in the Constant-Murley shoulder joint function score in the distal locking plate group was better than that in the clavicle hook plate group at 3 and 6 months after the operation (P < 0.05). There were fewer cases of shoulder joint pain and restricted shoulder abduction range of motion in the distal locking plate group, and the difference was statistically significant (P < 0.05). There were no statistically significant differences in fracture delay healing and subacromial impingement between the two groups (P > 0.05). Conclusion: Compared with the clavicular hook plate, the distal clavicle locking plate for the treatment of Neer type II distal clavicle fractures is associated with better shoulder function recovery and fewer complications related to pain and abduction restriction.

Introduction Clavicular fractures are common and typically occur in young patients, leading to a burden for this active population [1, 2]. Clavicle fractures are categorized as proximal, midshaft, or distal fractures. Although distal clavicle fractures represent only 15–28% of clavicle fracture cases, they constitute 30–45% of cases of nonunion [3–5]. Therefore, surgical management is recommended for all unstable distal clavicle fractures [6]. Controversy exists regarding the optimal treatment for vertically unstable Neer type II lateral clavicle fractures [7]. Strategies for the treatment of clavicular fractures include coracoclavicular fixation (sutures such as a tight rope or * Correspondence: [email protected] † Liang Li and Tian-yan Li contributed equally to this work. Department of Orthopaedics, Dongying People’s Hospital, No. 317 Dongcheng South First Road, Dongying 257091, Shandong, China

endobutton and screw) and fracture fixation devices (clavicular hook plate, clavicular locking plate and screw with lateral extension, tension band wiring and transacromial pinning with