Vol. 2, Issue 1, Part M (2016)

Purpose: Hook plate fixation is one of the most frequently used methods for unstable distal clavicular fractures, but it is still unknown if there is a need for coracoclavicular (CC) reconstruction. This study aimed to compare the efficacy of hook plate fixation with versus without CC reconstruction for distal clavicular fractures.

Methods: Eighty-one patients who underwent hook plate fixation (HP group, n = 45) or hook plate fixation plus suture anchor reconstruction (HPA group, n = 36) for Neer type II or V clavicular fractures were enrolled. Demographics, fracture characteristics, and surgical data were recorded. Union time, coracoclavicular distance (CCD), post-operative complications, Constant score, and Disabilities of the Arm, Shoulder, and Hand (DASH) score were compared between HPA and HP groups.

Results: Constant score in the HPA group was higher than that in the HP group (91.8±3.6 vs 88.8±6.0, P = 0.007). However, there were no significant differences in union time, DASH score, CCD, and post-operative complications between the two groups (p> 0.05). Hook plate fixation combined with CC reconstruction costed more (3023.7±202.6 vs

2416.2±167.6 EUR, p< 0.001) and prolonged operative duration (78.2±9.2 vs 73.7±8.3 min, P = 0.023) compared with hook plate fixation alone.

Conclusion: Hook plate fixation with or without suture anchor reconstruction achieved satisfactory outcomes for Neer type II or V clavicular fractures. However, hook plate fixation plus CC reconstruction showed better functional outcomes compared with hook plate fixation alone.