A comparative study of three internal fixation methods for distal clavicle fractures

LI Liang; XU Hai-ning; XU Rui-sheng; JI Xu-bin

doi:10.3969/j.issn.1009-4237.2018.03.009

Abstract：Objective To explore clinical and radiographic outcomes of three internal fixation methods in treatment of distal clavicle fractures.Methods Data of 63 patients with distal clavicle fracture were retrospectively analyzed,who were admitted to our department from Jan.2011 to May 2013.Among them,18 patients were treated with distal clavicular anatomical plate(group A),24 patients were treated with clavicular hook plate(group B),and 21 patients were treated with double mini-plate(group C).According to Craig classification of fractures,there were 15 patients with Craig Ⅱ/type Ⅱ and 3 with Craig Ⅱ/type V in Group A;20 with Craig Ⅱ/type Ⅱ and 4 with Craig Ⅱ/type V in Group B;18 with CraigⅡ/typeⅡand 3 with CraigⅡ/type V in Group C.The general preoper-ative data of the three groups were comparable.The functional recovery of the shoulder joint was assessed using the American Shoulder and Elbow Surgeons(ASES)rating scale score.A retrospective study was performed to compare the outcomes of the 3 methods regarding bone union and complications.Results The patients were followed up for 13 to 19 months(average,17.2 months).According to the Constant-Murley evaluation standard,the excellence rates of the three groups were 94.4%,75.0%,90.5%,respectively,which was higher in groups A and C than group B (P<0.001).The rate of complication in group B was 16.7%,which was significantly higher than that in group A (0)and group C(4.8%),with statistical difference among the three groups(P<0.05).Conclusion All three internal fixation techniques can attain good clinical outcomes in treatment of distal clavicle fractures.The distal cla-vicular anatomical plate fixation and double mini-plate fixation can effectively decrease the incidence of shoulder pain,and greatly reduce the incidence of limited shoulder movement.