Comparative study of three different fixation techniques for the treatment of Neer type IIb distal clavicle fractures: A retrospective cohort study

Zhi-Qing Liu; Ming-Shi Zhang; Zi-Fei Zhou; Lei Zhang; Long-Po Zheng

doi:10.3389/fsurg.2023.1100720

Comparative study of three different fixation techniques for the treatment of Neer type IIb distal clavicle fractures: A retrospective cohort study

Front Surg. 2023 Feb 6:10:1100720. doi: 10.3389/fsurg.2023.1100720. eCollection 2023.

Authors

Zhi-Qing Liu¹, Ming-Shi Zhang¹, Zi-Fei Zhou¹, Lei Zhang¹, Long-Po Zheng¹

Affiliation

¹ Department of Orthopedics, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.

Abstract

Background: Recently, a locking plate (LP) combined with a suture button was applied for distal clavicle Neer type IIb fractures. However, to our knowledge, there is limited information on clinical outcomes surrounding locking plates combined with a suture button in the treatment of Neer type IIb distal clavicle fractures. The aim of this study was to compare the outcomes among three different fixation techniques for the treatment of Neer type IIb distal clavicle fractures.

Methods: We performed a retrospective cohort study of 53 patients with Neer type IIb distal clavicle fractures who were treated with a hook plate (HP group, 16 patients), a locking plate alone (LP group, 18 patients), or a locking plate with a suture button (LPSB group, 19 patients) in our hospital between March 2014 and August 2019. The clinical and radiological outcomes were evaluated, including union time, postoperative complications, and function of the shoulder joint.

Results: The follow-up period was at least 2 years for all patients. All patients in the LPSB group achieved bone healing at the final follow-up. No significant differences were observed, including age, sex, side, time to surgery, duration of surgery, and mean follow-up period among the three groups (p > 0.05). The union time was shorter in the LPSB group than in the other two groups (p < 0.05). Postoperative complications were lower in the LPSB group than in the other two groups (p < 0.05). The visual analog scale score and Constant-Murley score in the LPSB group were better than those in the other groups at 3 and 6 months postoperatively (p < 0.05).

Conclusion: Compared with HP and LP alone, LPSB yields better clinical outcomes and lower complication rates in the treatment of Neer type IIb distal clavicle fractures.

Keywords: Neer type IIb distal clavicle fractures; complications; locking plate; outcome; suture button.

Grants and funding

This study was supported by the National Key R&D Program of China (grant no. 2017YFC0110600 to L-PZ), the Orthopedic Intelligent Minimally Invasive Diagnosis & Treatment Center, Shanghai Tenth People's Hospital (grant no. 04.99.18006 to L-PZ), the Science and Technology Commission of Shanghai Municipality (grant no. 18441901300 to L-PZ), the Fundamental Research Funds for the Central Universities (grant no. 22120180385 to LZ), and the Cultivation Project of National Natural Science Foundation of China for Shanghai Tenth People's Hospital (grant no. 04.03.20127 to LZ). The funding bodies played no role in the study design, in the collection, analysis and interpretation of data, in the writing of the paper, and in the decision to submit the paper for publication.