On the other hand, isolated distal locking plates (DLPs), though not technically associated with the aforementioned complications, it had been reported to have higher rates of delayed union and nonunion of up to 10% along with the incapacity of fully restoring the CC height. Nonetheless, it comes with its own share of complications, such as shoulder impingement causing long-term pain and decreased abduction, erosion of the acromion leading to osteolysis, arthritis of the ACJ, and the need of a second operative visit for the removal of the metal. Ī hook plate (HP) is commonly used as a spanning device in the management of distal clavicle fractures, it has the capability of restoring the CC height and maintaining stability by being hooked under the acromion. Injuries to the lateral third of the clavicle could lead to disruption of the coracoclavicular (CC) ligament compromising the stability of the fracture and the acromioclavicular joint (ACJ), thus, resulting in higher rates of malunion and nonunion. Complications were significantly higher in the HP group (P<0.0001).Ĭontrary to our hypothesis, though HP did show a better radiological outcome nonetheless, DLP did demonstrate a better functional result with a lesser rate of complications and the ability to retain the implant avoiding a second surgery.ĭistal clavicle fractures account for about 10%-30% of all clavicle fractures and 50% of nonunion cases. In terms of CCD, the comparison favoured the HP with a lesser CCD postoperatively and a statistically significant difference (P<0.05). VAS was in favour of the DLP with again no statistically significant difference (P=0.12). CMS leaned towards the DLP group with no statistically significant difference (P=0.06). The mean follow up was 38.7 and 37.03 months for HP and DLP, respectively. The total number of patients was 523 274 (52.3%) with HP and 249 (47.6%) with DLP, 81 of which were associated with CC reconstruction. Review manager software was used for the statistical analyses. Constant-Murley score “CMS” at a minimum of 12 months, pain visual analogue scale “VAS”, coracoclavicular distance “CCD” and reported complications were analysed. ![]() ![]() Comparative retrospective/prospective and randomized studies were incorporated. PubMed, Embase via Ovid and Web of science were electronically searched between January 2000 and to date for studies directly comparing HP to DLP. Thus, the aim of the study is to conduct a comparative analysis, hopefully, to recommend the superior method between the two operations. Hook plate (HP) and distal locking plate (DLP) are among the commonly used techniques nonetheless, no single procedure is deemed to be the benchmark treatment. Numerous interventions are advised for the surgical management of distal clavicle fractures.
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