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Archives of Orthopaedic and Trauma Surgery

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05.01.2022 | Trauma Surgery

A systematic review and meta-analysis comparing the use of hook plates and superior plates in the treatment of displaced distal clavicle fractures

verfasst von: Shahbaz S. Malik, Muaaz Tahir, Mohammedabbas Remtulla, Sheraz Malik, Robert W. Jordan

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 1/2023

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Abstract

Introduction

Non-operative treatment of displaced distal clavicle fractures results in high non-union and yet there is no consensus on superior treatment modality. While there are a number of different techniques available for fixation, hook plate (HP) has been used most commonly. A number of modern techniques, including superior plate (SP), have shown less complications but equivocal union rate and shoulder function. The aim of this systematic review and meta-analysis is to compare the outcome of HP fixation with superior plate in surgical fixation of displaced distal clavicle fractures.

Patients and methods

A review of the online databases MEDLINE and Embase was conducted on 15 January 2021 according to PRISMA guidelines. The review was registered prospectively in the PROSPERO database. Clinical studies reporting union rate, complications and shoulder function were included. The studies were appraised using the Methodological Index for Non-Randomized Studies (MINORS) tool.

Results

The search strategy identified 42 studies eligible for inclusion with a total of 1,261 patients. These included 17 hook-plate case series (n = 573), 18 superior plate case series, of which 6 used SP alone (n = 223) and 12 SP and simultaneous CCLR case series (n = 189), and 7 studies comparing HP and SP (n = 276). The overall complication rate was significantly higher with HP when compared to SP [(32.7% vs 12.7%; OR 6.31 (95% CI: 2.67–14.91)]. The overall union rates in the case series appeared comparable in the current SR; HP 96.4%, SP 96.9% and SP with simultaneous CCLR 97.9%. Shoulder function was most commonly assessed using CM score and the mean ranged from 83.8 to 97.2 in HP, 89 to 98 in SP group and 90.6 to 97.6 in SP with CCLR. Meta-analysis of CM score failed to show a significant difference for HP versus SP (pooled weighted mean difference was 2.67 (95% CI: – 0.09 to 5.43) with a trend to favour SP fixation.

Conclusion

The current review has demonstrated that HP, SP alone or with CCLR all offer excellent union rate and appear to provide comparative functional outcomes. However, HP is associated with significantly higher complication rates.

Postacchini F, Gumina S, De Santis P, Albo F (2002) Epidemiology of clavicle fractures. J Shoulder Elbow Surg 11:452–456. https://doi.org/10.1067/mse.2002.126613CrossRef

Nordqvist A, Petersson C, Redlund-Johnell I (1993) The natural course of lateral clavicle fracture. 15 (11–21) year follow-up of 110 cases. Acta Orthop Scand 64:87–91. https://doi.org/10.3109/17453679308994539CrossRef

Allman FL (1967) Fractures and ligamentous injuries of the clavicle and its articulation. J Bone Joint Surg Am 49:774–784CrossRef

Kavanagh TG, Sarkar SD (1985) Complications of displaced fractures (type-II Neer) of the outer end of the clavicle. In: journal of bone and joint surgery-British volume. British editorial Soc bone joint surgery 22 Buckingham street, London …, pp 492–493

Robinson CM (1998) Fractures of the clavicle in the adult. Epidemiology and classification. J Bone Joint Surg Br 80:476–484. https://doi.org/10.1302/0301-620x.80b3.8079CrossRef

Jupiter JB, Leffert RD (1987) Non-union of the clavicle. Associated complications and surgical management. J Bone Joint Surg Am 69:753–760CrossRef

Robinson CM, Cairns DA (2004) Primary nonoperative treatment of displaced lateral fractures of the clavicle. J Bone Joint Surg Am 86:778–782. https://doi.org/10.2106/00004623-200404000-00016CrossRef

Edwards DJ, Kavanagh TG, Flannery MC (1992) Fractures of the distal clavicle: a case for fixation. Injury 23:44–46. https://doi.org/10.1016/0020-1383(92)90125-cCrossRef

Oh JH, Kim SH, Lee JH et al (2011) Treatment of distal clavicle fracture: a systematic review of treatment modalities in 425 fractures. Arch Orthop Trauma Surg 131:525–533. https://doi.org/10.1007/s00402-010-1196-yCrossRef

10.

Stegeman SA, Nacak H, Huvenaars KH et al (2013) Surgical treatment of Neer type-II fractures of the distal clavicle: a meta-analysis. Acta Orthop 84:184–190. https://doi.org/10.3109/17453674.2013.786637CrossRef

11.

Khan LAK, Bradnock TJ, Scott C, Robinson CM (2009) Fractures of the clavicle. J Bone Joint Surg Am 91:447–460. https://doi.org/10.2106/JBJS.H.00034CrossRef

12.

Moher D, Liberati A, Tetzlaff J et al (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6:e1000097. https://doi.org/10.1371/journal.pmed.1000097CrossRef

13.

Slim K, Nini E, Forestier D et al (2003) Methodological index for non-randomized studies (MINORS): development and validation of a new instrument. ANZ J Surg 73:712–716. https://doi.org/10.1046/j.1445-2197.2003.02748.xCrossRef

14.

DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7:177–188. https://doi.org/10.1016/0197-2456(86)90046-2CrossRef

15.

Higgins JPT, Thompson SG (2002) Quantifying heterogeneity in a meta-analysis. Stat Med 21:1539–1558. https://doi.org/10.1002/sim.1186CrossRef

16.

Baunach D, Eid K, Ricks M, Borbas P (2020) Long-term clinical and radiological results after hook plate osteosynthesis of lateral clavicle fractures. J Orthop Trauma. https://doi.org/10.1097/BOT.0000000000002007CrossRef

17.

Drijfhout van Hooff CC, Haverlag R, Willems WJ (2013) Evaluation of the use of the hook plate in Neer type 2 lateral clavicle fractures and Rockwood types 3–5 acromioclavicular joint dislocations. Eur J Trauma Emerg Surg Off Publ Eur Trauma Soc 39:619–626. https://doi.org/10.1007/s00068-013-0303-5CrossRef

18.

Flinkkilä T, Ristiniemi J, Lakovaara M et al (2006) Hook-plate fixation of unstable lateral clavicle fractures: a report on 63 patients. Acta Orthop 77:644–649. https://doi.org/10.1080/17453670610012737CrossRef

19.

Good DW, Lui DF, Leonard M et al (2012) Clavicle hook plate fixation for displaced lateral-third clavicle fractures (Neer type II): a functional outcome study. J Shoulder Elbow Surg 21:1045–1048. https://doi.org/10.1016/j.jse.2011.07.020CrossRef

20.

Haidar SG, Krishnan KM, Deshmukh SC (2006) Hook plate fixation for type II fractures of the lateral end of the clavicle. J Shoulder Elbow Surg 15:419–423. https://doi.org/10.1016/j.jse.2005.11.012CrossRef

21.

Hsu T-L, Hsu S-K, Chen H-M, Wang S-T (2010) Comparison of hook plate and tension band wire in the treatment of distal clavicle fractures. Orthopedics. https://doi.org/10.3928/01477447-20101021-04CrossRef

22.

Kashii M, Inui H, Yamamoto K (2006) Surgical treatment of distal clavicle fractures using the clavicular hook plate. Clin Orthop 447:158–164. https://doi.org/10.1097/01.blo.0000203469.66055.6aCrossRef

23.

Lee W, Choi C-H, Choi Y-R et al (2017) Clavicle hook plate fixation for distal-third clavicle fracture (Neer type II): comparison of clinical and radiologic outcomes between Neer types IIA and IIB. J Shoulder Elbow Surg 26:1210–1215. https://doi.org/10.1016/j.jse.2016.11.046CrossRef

24.

Lee Y-S, Lau M-J, Tseng Y-C et al (2009) Comparison of the efficacy of hook plate versus tension band wire in the treatment of unstable fractures of the distal clavicle. Int Orthop 33:1401–1405. https://doi.org/10.1007/s00264-008-0696-7CrossRef

25.

Leu T-H, Ho W-P, Wong P-K et al (2012) Clavicular Hook plate: a better implant choice for fixation of unstable distal clavicle fractures? J Exp Clin Med 4:270–274. https://doi.org/10.1016/j.jecm.2012.09.002CrossRef

26.

Lopiz Y, Checa P, García-Fernández C et al (2019) Complications with the clavicle hook plate after fixation of Neer type II clavicle fractures. Int Orthop 43:1701–1708. https://doi.org/10.1007/s00264-018-4108-3CrossRef

27.

Meda PVK, Machani B, Sinopidis C et al (2006) Clavicular hook plate for lateral end fractures:- a prospective study. Injury 37:277–283. https://doi.org/10.1016/j.injury.2005.10.017CrossRef

28.

Muramatsu K, Shigetomi M, Matsunaga T et al (2007) Use of the AO hook-plate for treatment of unstable fractures of the distal clavicle. Arch Orthop Trauma Surg 127:191–194. https://doi.org/10.1007/s00402-006-0284-5CrossRef

29.

Renger R, Roukema G, Reurings J et al (2009) The clavicle hook plate for Neer type II lateral clavicle fractures. J Orthop Trauma 23:570–574. https://doi.org/10.1097/BOT.0b013e318193d878CrossRef

30.

Tambe AD, Motkur P, Qamar A et al (2006) Fractures of the distal third of the clavicle treated by hook plating. Int Orthop 30:7–10. https://doi.org/10.1007/s00264-005-0019-1CrossRef

31.

Tiren D, van Bemmel AJM, Swank DJ, van der Linden FM (2012) Hook plate fixation of acute displaced lateral clavicle fractures: mid-term results and a brief literature overview. J Orthop Surg 7:2. https://doi.org/10.1186/1749-799X-7-2CrossRef

32.

Wu K, Chang C-H, Yang R-S (2011) Comparing Hook Plates and Kirschner tension band wiring for unstable lateral clavicle. Fractures. https://doi.org/10.3928/01477447-20110922-17CrossRef

33.

Fleming MA, Dachs R, Maqungo S et al (2015) Angular stable fixation of displaced distal-third clavicle fractures with superior precontoured locking plates. J Shoulder Elbow Surg 24:700–704. https://doi.org/10.1016/j.jse.2014.09.024CrossRef

34.

Furuhata R, Takahashi M, Hayashi T et al (2020) Treatment of distal clavicle fractures using a Scorpion plate and influence of timing on surgical outcomes: a retrospective cohort study of 105 cases. BMC Musculoskelet Disord 21:146. https://doi.org/10.1186/s12891-020-3169-9CrossRef

35.

Lee SK, Lee JW, Song DG, Choy WS (2013) Precontoured locking plate fixation for displaced lateral clavicle fractures. Orthopedics 36:801–807. https://doi.org/10.3928/01477447-20130523-28CrossRef

36.

Shin S-J, Ko Y-W, Lee J, Park M-G (2016) Use of plate fixation without coracoclavicular ligament augmentation for unstable distal clavicle fractures. J Shoulder Elbow Surg 25:942–948. https://doi.org/10.1016/j.jse.2015.10.016CrossRef

37.

Tiren D, Vroemen JPAM (2013) Superior clavicle plate with lateral extension for displaced lateral clavicle fractures: a prospective study. J Orthop Traumatol 14:115–120. https://doi.org/10.1007/s10195-013-0228-0CrossRef

38.

Vaishya R, Vijay V, Khanna V (2017) Outcome of distal end clavicle fractures treated with locking plates. Chin J Traumatol 20:45–48. https://doi.org/10.1016/j.cjtee.2016.05.003CrossRef

39.

Andersen JR, Willis MP, Nelson R, Mighell MA (2011) Precontoured superior locked plating of distal clavicle fractures: a new strategy. Clin Orthop 469:3344–3350. https://doi.org/10.1007/s11999-011-2009-5CrossRef

40.

Beirer M, Siebenlist S, Crönlein M et al (2014) Clinical and radiological outcome following treatment of displaced lateral clavicle fractures using a locking compression plate with lateral extension: a prospective study. BMC Musculoskelet Disord 15:380. https://doi.org/10.1186/1471-2474-15-380CrossRef

41.

Han L, Hu Y, Quan R et al (2017) Treatment of Neer IIb distal clavicle fractures using anatomical locked plate fixation with coracoclavicular ligament augmentation. J Hand Surg 42:1036.e1-1036.e6. https://doi.org/10.1016/j.jhsa.2017.08.005CrossRef

42.

Herrmann S, Schmidmaier G, Greiner S (2009) Stabilisation of vertical unstable distal clavicular fractures (Neer 2b) using locking T-plates and suture anchors. Injury 40:236–239. https://doi.org/10.1016/j.injury.2008.07.021CrossRef

43.

Hohmann E, Hansen T, Tetsworth K (2012) Treatment of Neer type II fractures of the lateral clavicle using distal radius locking plates combined with TightRope augmentation of the coraco-clavicular ligaments. Arch Orthop Trauma Surg 7

44.

Johnston PS, Sears BW, Lazarus MR, Frieman BG (2014) Fixation of unstable type II clavicle fractures with distal clavicle plate and suture button. J Orthop Trauma 28:e269–e272. https://doi.org/10.1097/BOT.0000000000000081CrossRef

45.

Kalamaras M, Cutbush K, Robinson M (2008) A method for internal fixation of unstable distal clavicle fractures: early observations using a new technique. J Shoulder Elbow Surg 17:60–62. https://doi.org/10.1016/j.jse.2007.04.012CrossRef

46.

Largo RD, Rudin MA, Hotz TK et al (2011) Anatomic reconstruction of unstable lateral clavicular fractures. J Trauma Inj Infect Crit Care 71:1348–1351. https://doi.org/10.1097/TA.0b013e3182095dd1CrossRef

47.

Martetschläger F, Kraus TM, Schiele CS et al (2013) Treatment for unstable distal clavicle fractures (Neer 2) with locking T-plate and additional PDS cerclage. Knee Surg Sports Traumatol Arthrosc 21:1189–1194. https://doi.org/10.1007/s00167-012-2089-0CrossRef

48.

Nandra R, Kowalski T, Kalogrianitis S (2017) Innovative use of single-incision internal fixation of distal clavicle fractures augmented with coracoclavicular stabilisation. Eur J Orthop Surg Traumatol 27:1057–1062. https://doi.org/10.1007/s00590-017-1977-xCrossRef

49.

Schliemann B, Roßlenbroich SB, Schneider KN et al (2013) Surgical treatment of vertically unstable lateral clavicle fractures (Neer 2b) with locked plate fixation and coracoclavicular ligament reconstruction. Arch Orthop Trauma Surg 133:935–939. https://doi.org/10.1007/s00402-013-1737-2CrossRef

50.

Seyhan M, Kocaoglu B, Kiyak G et al (2015) Anatomic locking plate and coracoclavicular stabilization with suture endo-button technique is superior in the treatment of Neer Type II distal clavicle fractures. Eur J Orthop Surg Traumatol 25:827–832. https://doi.org/10.1007/s00590-015-1617-2CrossRef

51.

Erdle B, Izadpanah K, Jaeger M et al (2017) Comparative analysis of locking plate versus hook plate osteosynthesis of Neer type IIB lateral clavicle fractures. Arch Orthop Trauma Surg 137:651–662. https://doi.org/10.1007/s00402-017-2645-7CrossRef

52.

Singh A, Schultzel M, Fleming JF, Navarro RA (2019) Complications after surgical treatment of distal clavicle fractures. Orthop Traumatol Surg Res 105:853–859. https://doi.org/10.1016/j.otsr.2019.03.012CrossRef

53.

Tan H-L, Zhao J-K, Qian C et al (2012) Clinical results of treatment using a clavicular hook plate versus a T-plate in neer type II distal clavicle fractures. Orthopedics 35:e1191-1197. https://doi.org/10.3928/01477447-20120725-18CrossRef

54.

Xiong J, Chen J-H, Dang Y et al (2018) Treatment of unstable distal clavicle fractures (Neer type II): a comparison of three internal fixation methods. J Int Med Res 46:4678–4683. https://doi.org/10.1177/0300060518788245CrossRef

55.

Zhang C, Huang J, Luo Y, Sun H (2014) Comparison of the efficacy of a distal clavicular locking plate versus a clavicular hook plate in the treatment of unstable distal clavicle fractures and a systematic literature review. Int Orthop 38:1461–1468. https://doi.org/10.1007/s00264-014-2340-zCrossRef

56.

Bhatia DN, Page RS (2012) Surgical treatment of lateral clavicle fractures associated with complete coracoclavicular ligament disruption: clinico-radiological outcomes of acromioclavicular joint sparing and spanning implants. Int J Shoulder Surg 6:116–120. https://doi.org/10.4103/0973-6042.106224CrossRef

57.

Klein SM, Badman BL, Keating CJ et al (2010) Results of surgical treatment for unstable distal clavicular fractures. J Shoulder Elbow Surg 19:1049–1055. https://doi.org/10.1016/j.jse.2009.11.056CrossRef

58.

Asadollahi S, Bucknill A (2019) Hook plate fixation for acute unstable distal clavicle fracture: a systematic review and meta-analysis. J Orthop Trauma 33:417–422. https://doi.org/10.1097/BOT.0000000000001481CrossRef

59.

Rieser GR, Edwards K, Gould GC et al (2013) Distal-third clavicle fracture fixation: a biomechanical evaluation of fixation. J Shoulder Elbow Surg 22:848–855. https://doi.org/10.1016/j.jse.2012.08.022CrossRef

Titel: A systematic review and meta-analysis comparing the use of hook plates and superior plates in the treatment of displaced distal clavicle fractures
verfasst von: Shahbaz S. Malik
Muaaz Tahir
Mohammedabbas Remtulla
Sheraz Malik
Robert W. Jordan
Publikationsdatum: 05.01.2022
Verlag: Springer Berlin Heidelberg
Erschienen in: Archives of Orthopaedic and Trauma Surgery / Ausgabe 1/2023
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-021-04287-z

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A systematic review and meta-analysis comparing the use of hook plates and superior plates in the treatment of displaced distal clavicle fractures