Curative effect of double Endo-button belt loops plate technique for the treatment of Neer type Ⅱ distal clavicle fractures

LU Si-yuan; FENG Hong-wei; ZHANG Jian-luo; XIAO Bin; XIONG Fu-jun; YANG Hong-tao; ZHOU Bai-gang

doi:10.3969/j.issn.1009-4237.2017.10.006

Abstract：Objective To explore the efficacy of double Endobutton belt loops plate for the treatment of NeerⅡ type clavicle distal fracture. Methods Retrospective analysis of 21 cases of fracture (15 males and 6 fe-males,aged from 21 to 58 with an average of 37 years) treated in the orthopedics dept. No. 1 of the 215 Hospital of Shanxi Nuclear Industry from May 2010 to May 2014 was carried out. The fracture type of the selected patients was all Neer type Ⅱ distal clavicle fracture accompanied with coracoclavicular ligament rupture. With the clavicular check point of the coracoclavicular ligament as the center,an incision along the clavicle was made. A Kirschner nee-dle ( diameter=2 mm) was drilled through the clavicle and coracoid and then a hollow drill ( diameter=4. 5 mm) was drilled through the clavicle and coracoid protrusion following the Kirschner needle to make two interconnected bone channels. The length of the bone channels and the distance between the two channels were measured. Guided by the orthopedics 2# thread,2 interlocked steel plates with loops (Johnson,batch number: L50527339) were pas-sed through the bone channels and finally suspended on the upper surface of the clavicle and the lower surface of the clavicular coracoid process respectively. Along the trapezoid ligment, the guide line at the coracoid end was led through the other channel at the distal end of the clavicle and tied up. At the time point of 1,6 months after surgery, the treatment effects were evaluated according to the Constant-Murley scoring system. Results All patients were followed up from 6 to 30 months with an average of 12 months. The data of X-ray showed a good reduction in frac-ture and the fracture healing time ranged from 5 to 12 weeks with an average of 6. 5 weeks. All patients resumed shoulder activity 2 months after operation. The average Constant-Murley scores 1 month and 6 months after surgery were 83. 5 (64 to 91,1 case of excellent,13 cases of good and 7 cases of poor) and 93 (89 to 98,19 cases of excel-lent and 2 cases of good),respectively. Till the last follow-up,complications such as shoulder pain,infection and fracture dislocation and delayed healing did not appear. Conclusion Treatment with double endo-button belt loops plate has good effect for Neer type Ⅱ distal clavicle fracture,which is worthy of promotion.