Open Access, Peer-reviewed, Quarterly
pISSN 1225-1682
eISSN 2287-9293
    J Korean Fract Soc. 2011 Jan;24(1):55-59. Korean.
    Published online Jan 19, 2011.
    https://doi.org/10.12671/jkfs.2011.24.1.55
    Copyright © 2011 The Korean Fracture Society
    Original Article

    Comparison of Results of Tension Band Wire and Hook Plate in the Treatment of Unstable Fractures of the Distal Clavicle

    Chul-Hyun Park, M.D., Oog-Jin Shon, M.D., and Jae-Sung Seo, M.D.
      • Department of Orthopedic Surgery, Yeungnam University Hospital, Daegu, Korea.
    • Address reprint requests to: Oog-Jin Shon, M.D. Department of Orthopedic Surgery, Yeungnam University Hospital, 317-1, Daemyeong-dong, Nam-gu, Daegu 705-717, Korea. Tel: 82-53-620-3640·Fax: 82-53-628-4020, Email: ossoj@med.yu.ac.kr
    Received August 11, 2010; Revised September 13, 2010; Accepted October 23, 2010.

    This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

    Abstract

    Purpose

    To compare the clinical and radiological outcomes of two surgical methods with tension band wire and Hook plate for unstable distal clavicle fractures.

    Materials and Methods

    Thirty patients with type II distal clavicle fractures were evaluated, who were operated with tension band wire (Group I) and Hook plate (Group II) fixation, from June 2005 to June 2009, and could be followed-up for more than 1 year after operation. The reduction and union were evaluated by the immediate post-operative and final radiographs. The functional outcome was evaluated by Kona's system and Constant-Murley scoring system.

    Results

    All 30 cases showed bony union. By Kona's functional evaluation, there were 16 cases with excellent and good results in Group I and 14 cases in Group II. The average Constant score was 88.3 (71~100) in Group I and 89.6 (72~100) in Group II, but there was no significant difference in both groups. As complications, there were 2 case with subacromial impingement, and 1 case showed subacromial erosion. There was no K-wire migration, deep infection and acromioclavicular joint arthritis.

    Conclusion

    Tension band and Hook plate fixation technique gave satisfactory clinical and radiological results in patients with type II distal clavicle fractures. These results suggest that tension band wire and Hook plate fixation technique seems to be an effective method for type II distal clavicle fracture. But we think thal early removal of plate is necessary due to risks for subacromial impingement and erosion in Hook plate fixation.

    Keywords
    Distal clavicle; Fracture; Neer type II; Tension band fixation; Hook plate fixation

    Figures

    Fig. 1
    (A) Radiograph of 56-year-old male shows Neer type II distal clavicle fracture.

    (B) Satisfactory reduction and tension band wire fixation without acromioclavicular joint injury were seen in immediate postoperative radiograph.

    (C, D) Bony union was seen in postperative 6 months radiograph and there were no K-wire migration and acromioclavicular joint arthritis.

    Fig. 2
    (A) Radiograph of 57-year-old male shows Neer type II distal clavicle fracture.

    (B) Satisfactory reduction and Hook plate fixation were seen in immediate postoperative radiograph.

    (C) Proximal screw loosening & plate migration were seen in postperative 6 months radiograph and there was subacromial impingment symptom.

    (D) After the operation of Hook plate removal, radiographs show good bony union and impingment symptom was disappeared.

    References

      1. Ahn BW, Yoon JH, Kim CK, et al. Internal fixation of clavicle lateral and fracture with mini T-plate. J Korean Fract Soc 2005;18:410–414.
      1. Balser D. Eine neue Moethode zur operativen Behandlung der akromioklavikularen Luxation. Chir Prax 1976;24:275–281.
      1. Chun JM, Kim SY, Lee KW, Shin SJ, Kim EG. Modified tenson band fixation for unstable fracture of the distal clavicle. J Korean Orthop Assoc 2002;37:416–420.
      1. Constant CR, Murley AH. A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 1987;214:160–164.
      1. Eberle C, Fodor P, Metzger U. Hook plate (so-called Balser plate) or tension banding with the Bosworth screw in complete acromioclavicular dislocation and clavicular fracture. Z Unfallchir Versicherungsmed 1992;85:134–139.
      1. Edwards DJ, Kavanagh TG, Flannery MC. Fractures of the distal clavicle: a case for fixation. Injury 1992;23:44–46.
      1. Flinkkilä T, Ristiniemi J, Hyvönen P, Hämäläinen M. Surgical treatment of unstable fractures of the distal clavicle: a comparative study of Kirschner wire and clavicular hook plate fixation. Acta Orthop Scand 2002;73:50–53.
      1. Flinkkilä T, Ristiniemi J, Lakovaara M, Hyvönen P, Leppilahti J. Hook-plate fixation of unstable lateral clavicle fractures: a report on 63 patients. Acta Orthop 2006;77:644–649.
      1. Hackenbruch W, Regazzoni P, Schwyzer K. Surgical treatment of lateral clavicular fracture with the "clavicular hooked plate". Z Unfallchir Versicherungsmed 1994;87:145–152.
      1. Kao FC, Chao EK, Chen CH, Yu SW, Chen CY, Yen CY. Treatment of distal clavicle fracture using Kirschner wires and tension-band wires. J Trauma 2001;51:522–525.
      1. Kashii M, Inui H, Yamamoto K. Surgical treatment of distal clavicle fractures using the clavicular hook plate. Clin Orthop Relat Res 2006;447:158–164.
      1. Kona J, Bosse MJ, Staeheli JW, Rosseau RL. Type II distal clavicle fractures: a retrospective review of surgical treatment. J Orthop Trauma 1990;4:115–120.
      1. Meda PV, Machani B, Sinopidis C, Braithwaite I, Brownson P, Frostick SP. Clavicular hook plate for lateral end fractures:- a prospective study. Injury 2006;37:277–283.
      1. Mizue F, Shirai Y, Ito H. Surgical treatment of comminuted fractures of the distal clavicle using Wolter clavicular plates. J Nihon Med Sch 2000;67:32–34.
      1. Muramatsu K, Shigetomi M, Matsunaga T, Murata Y, Taguchi T. Use of the AO hook-plate for treatment of unstable fractures of the distal clavicle. Arch Orthop Trauma Surg 2007;127:191–194.
      1. Neer CS 2nd. Fractures of the distal third of the clavicle. Clin Orthop Relat Res 1968;58:43–50.
      1. Neviaser RJ, Neviaser JS, Neviaser TJ, Neviaser JS. A simple technique for internal fixation of the clavicle. A long term evaluation. Clin Orthop Relat Res 1975;109:103–107.
      1. Nordqvist A, Petersson C, Redlund-Johnell I. The natural course of lateral clavicle fracture 15 (11-21) year follow-up of 110 cases. Acta Orthop Scand 1993;64:87–91.
      1. Park JY, Seo JB, Kim MH, Yu JW. Tension band fixation for type II fracture of the distal clavicle. J Korean Fract Soc 2005;18:421–425.
      1. Renger RJ, Roukema GR, Reurings JC, Raams PM, Font J, Verleisdonk EJ. The clavicle hook plate for Neer type II lateral clavicle fractures. J Orthop Trauma 2009;23:570–574.
      1. Rowe CR. An atlas of anatomy and treatment of midclavicular fractures. Clin Orthop Relat Res 1968;58:29–42.
      1. Zenni EJ Jr, Krieg JK, Rosen MJ. Open reduction and internal fixation of clavicular fractures. J Bone Joint Surg Am 1981;63:147–151.
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    MeSH Terms
    Acromioclavicular Joint
    Clavicle
    Humans
    Metrics
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