Study on shape memory alloy embracing fixator in treatment of the proximal clavicle fracture.

This study was designed to investigate the application value of shape memory alloy embracing fixator in the treatment of proximal clavicle fracture. From April 2018 to October 2020, the fracture data of patients with proximal clavicle fractures treated with shape memory alloy embracing fixator were retrospectively analyzed, including 12 males and 8 females. The age of patients ranged from 34 to 66 years (mean, 43.4 years). According to Craig's classification, the patients were divided into the following groups: type CII (eight cases), type CIII (five cases), type CⅤ (seven cases), all of which were closed fractures without nerve or vascular injury. The fracture healing time and postoperative complications were observed, and the shoulder joint function was evaluated by Constant score. All patients were followed up for 13-19 months (average 15.6 months). The clavicle radiographs showed that all the 20 patients had bone union, and the fracture union time was 6-10 months (average 7.2 months). There were no complications such as internal fixation fracture and displacement. According to the Constant criterion, 13 cases were excellent and 5 cases were fair and 1 case was good. The treatment of proximal clavicle fracture with shape memory alloy embracing fixator is an effective treatment method with simple operation with satisfactory fixation effect and low complication rate, which is worthy of being widely used in clinical practice.

Comparison of four different internal fixation methods in the treatment of distal clavicle fractures.

This study compared the clinical efficacy of four internal fixation methods in the treatment of distal clavicle fractures, in an effort to guide appropriate selection and application in the clinic. Eighty-four patients with distal clavicle-comminuted fractures were treated with a distal clavicle anatomic plate (group A), clavicular hook plate (group B), double-plate vertical fixation (group C), or T-shaped steel plate internal fixation (group D). The Constant-Murley scoring system was used to evaluate the shoulder joint function. The fracture healing time, VAS, and postoperative complications were compared and analyzed among the four groups. According to the Constant-Murley evaluation standard, the excellent and good rates of the four groups were 94.4, 73.1, 95 and 80% in groups A-D, respectively. The excellent and good rates of Constant-Murley evaluation standard in groups A and C were significantly better than those in groups B and D (P<0.05). VAS in the distal clavicle anatomic plate group (group A), double-plate vertical fixation group (group C), and T-shaped steel plate internal fixation group (group D) were significantly better than the clavicular hook plate group (group B) (P<0.05). The incidence of postoperative complications in the clavicular hook plate group (group B) was 15.4% and in the T-shaped steel plate internal fixation group (group D) was 15%, which were significantly higher than those of the distal clavicle anatomic plate group (group A) and double-plate vertical internal fixation group (group C) (P<0.05). The treatment of distal clavicle fractures using either one of the four internal fixation techniques can obtain better clinical results. The distal clavicle anatomic plate and double-plate vertical internal fixation techniques are associated with a decreased incidence of shoulder pain, an increase in the range of motion of the shoulder, and a reduction in complications, and thus, are preferable for the early functional recovery of limbs.

Clavicle hook plate versus distal clavicle locking plate for Neer type II distal clavicle fractures.

BACKGROUND: The purpose of this meta-analysis was to compare clavicle hook plates versus distal clavicle locking plates for the treatment of Neer type II distal clavicle fractures. METHODS: PubMed (1996 to January 2019), Embase (1980 to January 2019), Web of Science (1990 to January 2019), the Cochrane Library (January 2019), and the China National Knowledge Infrastructure (January 2019) were systematically searched without language restrictions for literature retrieval. The Constant-Murley shoulder joint function score at 3 and 6 months after the operation and the postoperative complications after the operation (shoulder joint pain, abduction restriction, fracture delay healing, subacromial impingement) were the outcomes. Stata 12.0 was used for the meta-analysis. RESULTS: A total of 9 clinical trials involving 446 patients were finally included in this meta-analysis. The results showed that the improvement in the Constant-Murley shoulder joint function score in the distal locking plate group was better than that in the clavicle hook plate group at 3 and 6 months after the operation (P < 0.05). There were fewer cases of shoulder joint pain and restricted shoulder abduction range of motion in the distal locking plate group, and the difference was statistically significant (P < 0.05). There were no statistically significant differences in fracture delay healing and subacromial impingement between the two groups (P > 0.05). CONCLUSION: Compared with the clavicular hook plate, the distal clavicle locking plate for the treatment of Neer type II distal clavicle fractures is associated with better shoulder function recovery and fewer complications related to pain and abduction restriction.