Comparison of hook plate versus T-plate in the treatment of Neer type II distal clavicle fractures: a prospective matched comparative cohort study
Abstract Background This study aimed to compare the clinical and radiological outcomes of distal clavicle fracture fixation with a hook plate versus the standard non-locking T-plate for unstable Neer type II fractures. Methods A prospective matched cohort study including two groups of hook plates an...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-07-01
|
| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-022-03261-8 |
| _version_ | 1798037682038767616 |
|---|---|
| author | Mehdi Teimouri Hadi Ravanbod Amirhosein Farrokhzad Jamal Sabaghi Seyed Peyman Mirghaderi |
| author_facet | Mehdi Teimouri Hadi Ravanbod Amirhosein Farrokhzad Jamal Sabaghi Seyed Peyman Mirghaderi |
| author_sort | Mehdi Teimouri |
| collection | DOAJ |
| description | Abstract Background This study aimed to compare the clinical and radiological outcomes of distal clavicle fracture fixation with a hook plate versus the standard non-locking T-plate for unstable Neer type II fractures. Methods A prospective matched cohort study including two groups of hook plates and T-plates fixation was conducted in our two tertiary trauma centers. Patients with distal clavicle fractures Neer type II were assessed for union and the Constant-Murley score (CMS) at 1-, 3-, and 6-month follow-ups. Inadequate radiographic consolidation > 6 months after surgery was defined as non-union. Subscales of CMSpain, CMSactivities of daily living, CMSrange of motion (ROM), and CMSstrength were also compared between groups. According to recommendations, the implant was removed after union confirmation in the hook plate at a planned second surgery. Results Sixty consecutive patients were enrolled: 30 in the T-plate group and 30 in the hook plate group. CMS showed similar functional outcomes for T-plates and hook plates at all follow-ups (Month 6: 92.0 vs. 91.7, P = 0.45). However, on the month 1 follow-up, the T-plate group scored higher than the hook plate group for ROM and pain (CMSpain = 13.0 vs. 12.3, P = 0.03; CMSROM = 35.2 vs. 33.2, P = 0.002). Despite this, Pain, ROM, and other CMS domains were comparable between groups (P > 0.05). The mean time to union was 2.5 + 1.4 months for the T-plate group and 2.3 + 1.6 months for the hook plate group (P = 0.44). There was one fixation failure in each group and one periprosthetic fracture in the hook plate group (two revisions for the hook plates and one for T-plates, P = 1.00). Non-union and other complications were not observed. Conclusion Both surgical approaches resulted in full recovery and good function. However, in the hook plate group ROM and pain scores were lower at 1 month. Standard non-locking T-plates are a viable alternative to hook plates with low cost and promising outcomes for treating displaced distal clavicle fractures. |
| first_indexed | 2024-04-11T21:29:51Z |
| format | Article |
| id | doaj.art-d1788aa6112d4282b0ff3ef51f332f21 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T21:29:51Z |
| publishDate | 2022-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-d1788aa6112d4282b0ff3ef51f332f212022-12-22T04:02:08ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2022-07-0117111010.1186/s13018-022-03261-8Comparison of hook plate versus T-plate in the treatment of Neer type II distal clavicle fractures: a prospective matched comparative cohort studyMehdi Teimouri0Hadi Ravanbod1Amirhosein Farrokhzad2Jamal Sabaghi3Seyed Peyman Mirghaderi4Department of Orthopedic Surgery, Ayatollah Kashani Hospital, Isfahan University of Medical SciencesDepartment of Orthopedic Surgery, Al-Zahra Hospital, Isfahan University of Medical SciencesDepartment of Orthopedic Surgery, Ayatollah Kashani Hospital, Isfahan University of Medical SciencesDepartment of Orthopedic Surgery, Ayatollah Kashani Hospital, Isfahan University of Medical SciencesJoint Reconstruction Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical SciencesAbstract Background This study aimed to compare the clinical and radiological outcomes of distal clavicle fracture fixation with a hook plate versus the standard non-locking T-plate for unstable Neer type II fractures. Methods A prospective matched cohort study including two groups of hook plates and T-plates fixation was conducted in our two tertiary trauma centers. Patients with distal clavicle fractures Neer type II were assessed for union and the Constant-Murley score (CMS) at 1-, 3-, and 6-month follow-ups. Inadequate radiographic consolidation > 6 months after surgery was defined as non-union. Subscales of CMSpain, CMSactivities of daily living, CMSrange of motion (ROM), and CMSstrength were also compared between groups. According to recommendations, the implant was removed after union confirmation in the hook plate at a planned second surgery. Results Sixty consecutive patients were enrolled: 30 in the T-plate group and 30 in the hook plate group. CMS showed similar functional outcomes for T-plates and hook plates at all follow-ups (Month 6: 92.0 vs. 91.7, P = 0.45). However, on the month 1 follow-up, the T-plate group scored higher than the hook plate group for ROM and pain (CMSpain = 13.0 vs. 12.3, P = 0.03; CMSROM = 35.2 vs. 33.2, P = 0.002). Despite this, Pain, ROM, and other CMS domains were comparable between groups (P > 0.05). The mean time to union was 2.5 + 1.4 months for the T-plate group and 2.3 + 1.6 months for the hook plate group (P = 0.44). There was one fixation failure in each group and one periprosthetic fracture in the hook plate group (two revisions for the hook plates and one for T-plates, P = 1.00). Non-union and other complications were not observed. Conclusion Both surgical approaches resulted in full recovery and good function. However, in the hook plate group ROM and pain scores were lower at 1 month. Standard non-locking T-plates are a viable alternative to hook plates with low cost and promising outcomes for treating displaced distal clavicle fractures.https://doi.org/10.1186/s13018-022-03261-8Bone platesClavicleDistal clavicle fractureHook plateInternal fixatorsT-plate |
| spellingShingle | Mehdi Teimouri Hadi Ravanbod Amirhosein Farrokhzad Jamal Sabaghi Seyed Peyman Mirghaderi Comparison of hook plate versus T-plate in the treatment of Neer type II distal clavicle fractures: a prospective matched comparative cohort study Journal of Orthopaedic Surgery and Research Bone plates Clavicle Distal clavicle fracture Hook plate Internal fixators T-plate |
| title | Comparison of hook plate versus T-plate in the treatment of Neer type II distal clavicle fractures: a prospective matched comparative cohort study |
| title_full | Comparison of hook plate versus T-plate in the treatment of Neer type II distal clavicle fractures: a prospective matched comparative cohort study |
| title_fullStr | Comparison of hook plate versus T-plate in the treatment of Neer type II distal clavicle fractures: a prospective matched comparative cohort study |
| title_full_unstemmed | Comparison of hook plate versus T-plate in the treatment of Neer type II distal clavicle fractures: a prospective matched comparative cohort study |
| title_short | Comparison of hook plate versus T-plate in the treatment of Neer type II distal clavicle fractures: a prospective matched comparative cohort study |
| title_sort | comparison of hook plate versus t plate in the treatment of neer type ii distal clavicle fractures a prospective matched comparative cohort study |
| topic | Bone plates Clavicle Distal clavicle fracture Hook plate Internal fixators T-plate |
| url | https://doi.org/10.1186/s13018-022-03261-8 |
| work_keys_str_mv | AT mehditeimouri comparisonofhookplateversustplateinthetreatmentofneertypeiidistalclaviclefracturesaprospectivematchedcomparativecohortstudy AT hadiravanbod comparisonofhookplateversustplateinthetreatmentofneertypeiidistalclaviclefracturesaprospectivematchedcomparativecohortstudy AT amirhoseinfarrokhzad comparisonofhookplateversustplateinthetreatmentofneertypeiidistalclaviclefracturesaprospectivematchedcomparativecohortstudy AT jamalsabaghi comparisonofhookplateversustplateinthetreatmentofneertypeiidistalclaviclefracturesaprospectivematchedcomparativecohortstudy AT seyedpeymanmirghaderi comparisonofhookplateversustplateinthetreatmentofneertypeiidistalclaviclefracturesaprospectivematchedcomparativecohortstudy |