Application value of anatomical locking plate of distal clavicle combined with TightRope buckle and loop titanium plate suspension fixation in the treatment of Neer type Ⅱb distal clavicle fracture
Lu Junshuai, Ma Wenqian, Xu Xiaobin, Wang Yiqun, Gao Liceng, Zhu Wei
Department of Orthopedics, Songjiang Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai201600, China
Abstract:Objective This study aimed to explore the clinical value of the anatomical locking plate of the distal clavicle combined with TightRope buckle and loop titanium plate suspension fixation in the treatment of Neer type Ⅱb distal clavicle fracture. Methods This was a retrospective cohort study. The clinical data of 64 patients with Neer type IIb distal clavicular fracture diagnosed in the Department of Orthopedics, Songjiang Hospital Affiliated with Shanghai Jiao Tong University School of Medicine from January 2016 to February 2022 were included in this study. A total of 34 patients with distal clavicular anatomic locking plate fixation combined with TightRope loop titanium plate suspension for coracoclavicular ligament reconstruction were in the reconstruction group, and 30 patients with distal clavicular anatomic locking plate fixation were in the non-reconstruction group. In the reconstruction group, there were 20 males and 14 females, aged 20-70 (45.2± 12.5) years, 18 patients on the left side, and 16 patients on the right side. Meanwhile, in the non-reconstruction group, there were 19 males and 11 females, aged 18-65 (43.6± 13.8) years, 14 patients on the left side, and 16 patients on the right side. Operation time, intraoperative blood loss, hospital stay, and follow-up time were compared between the two groups. Constant-Murley score and visual analog scale (VAS) were used to evaluate shoulder joint function and pain before and after surgery in both groups. At the last follow-up, fracture healing time, increased rate of coracoclavicular distance, and incidence of complications in both groups were analyzed. Results The surgery of 64 patients was successful. No significant differences were found in age, gender, time from injury to operation, fracture side, injury cause, and other general data between the two groups (all P values > 0.05). In addition, no significant differences were observed in operation time, intraoperative blood loss, hospital stay, and follow-up time between the two groups (all P values > 0.05). At the last follow-up, the Constant-Murley and VAS scores of the reconstruction group were 93.1± 4.9 and 0.8± 0.3 points, respectively, which were statistically significant compared with the preoperative scores (42.7± 5.8) and (7.4± 0.7) points (t=38.70, 47.46, all P values < 0.05). Meanwhile, the Constant-Murley and VAS scores of the non-reconstruction group were (91.5± 4.8) and (0.9± 0.3) points, which were statistically significant compared with the preoperative scores of 43.5 ± 6.0 and 7.7± 0.8 points (t=36.42, 43.59, all P values < 0.05). Before the surgery, no significant differences were observed in the Constant-Murley and VAS scores between the two groups (all P values > 0.05). At the last follow-up, the Constant-Murley and VAS scores between the two groups were not statistically significant (t=1.36, 1.16, all P values > 0.05). In the reconstruction group, the fracture healing time was 12.2± 2.7 weeks and the increased rate of coracoclavicular distance was 12.7%± 13.6%, whereas in the non-reconstruction group, the fracture healing time was 13.4± 2.8 weeks and the increased rate of coracoclavicular distance was 14.6%± 14.8%. No significant differences were observed (t=1.75, 0.53, all P values > 0.05). The complication rate was 2.9% (1/34) and 33.3% (10/30) in the reconstructed group and the non-reconstructed group, respectively, and the difference between the two groups was statistically significant (χ2=10.34, P < 0.001). Conclusion Both distal clavicular anatomic locking plate fixation and TightRope loop titanium plate reconstruction of the coracoclavicular ligament can effectively fix the Neer type Ⅱb distal clavicular fracture. However, the latter method has better stability and a more satisfactory therapeutic effect than the former.
陆军帅, 麻文谦, 徐小彬, 王逸群, 高礼层, 朱玮. 锁骨远端解剖锁定钢板固定联合TightRope锁扣带袢钛板悬吊在NeerⅡb型锁骨远端骨折治疗中的应用价值[J]. 中华解剖与临床杂志, 2023, 28(7): 469-475.
Lu Junshuai, Ma Wenqian, Xu Xiaobin, Wang Yiqun, Gao Liceng, Zhu Wei. Application value of anatomical locking plate of distal clavicle combined with TightRope buckle and loop titanium plate suspension fixation in the treatment of Neer type Ⅱb distal clavicle fracture. Chinese Journal of Anatomy and Clinics, 2023, 28(7): 469-475.
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