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. 2006 Feb;30(1):7-10.
doi: 10.1007/s00264-005-0019-1. Epub 2005 Oct 19.

Fractures of the distal third of the clavicle treated by hook plating

A D Tambe  1 , P Motkur, A Qamar, S Drew, S M Turner
Affiliations

Fractures of the distal third of the clavicle treated by hook plating

A D Tambe et al. Int Orthop. 2006 Feb.

Abstract
in English, French

We retrospectively assessed the union and shoulder function following hook plate fixation in 18 patients with Neer type 2 fractures of the lateral end of the clavicle. The average age was 40 (range 22-62) years, and the mean follow-up was 25 (range 6-48) months. Fifteen patients had acute fractures and the rest were non-unions. Complications included two non-unions, one following a deep infection. There were no iatrogenic fractures. Acromial osteolysis was seen in five patients who had their plates in situ. The average pain score at rest was 1 (range 0-4), and the average pain score on abduction was 2.2 (range 0-5). The average Constant score was 88.5 (range 63-100). Patients were asked to rate their shoulder function; three rated it as normal, 11 as nearly normal and one as not normal. Hook plate fixation appears to be a valuable method of stabilising Neer type 2 fractures of the clavicle, resulting in high union rates and good shoulder function. These plates need to be removed after union to prevent acromial osteolysis.

Nous avons étudié rétrospectivement, chez 18 malades, la consolidation des fractures du quart externe de la clavicule type 2 de Neer et la fonction de l'épaule, après fixation par plaque crochet. L'âge moyen était de 40 (20–62) ans et la moyenne de suivi de 25 (6–48) mois. Quinze avaient une fracture fraîche les autres une pseudarthrose. Les complications ont inclus deux non consolidations, dont l'une après une infection profonde. Il n'y avait pas de fracture iatrogénique. Une ostéolyse acromiale a été noté chez cinq malades qui avaient la plaque en place. Le score moyen de la douleur au repos était de 1 (0–4) et celui en abduction était de 2,2 (0–5). Le score moyen de Constant était de 88,5 (63–100). On a demandé aux patients d'estimer la fonction de leur épaule; trois ont dit que leur épaule était normale, onze ont dit qu'elle était presque normale et un a estimé quelle n'était pas normale. La fixation par plaque crochet paraît être une bonne méthode pour stabiliser les fractures de type Neer 2 de la clavicule, permettant un taux élevé de consolidation et une bonne fonction de l'épaule. Ces plaques ont besoin d'être enlevé après la consolidation pour prévenir l'ostéolyse de l'acromion.

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Figures

Fig. 1
Fig. 1
Patient 1: a 33-year-old man with hook plate with acromial osteolysis before plate removal
Fig. 2
Fig. 2
Patient 2: Neer type 2 fracture of clavicle in a 54-year-old man
Fig. 3
Fig. 3
Patient 2: post-operatively after hook plate fixation
Fig. 4
Fig. 4
Patient 2: post-operatively at 6 months prior to plate removal
Fig. 5
Fig. 5
Patient 2: X-ray after plate removal shows early osteophyte formation
See this image and copyright information in PMC

Comment in

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