ArticleScientific reports2025
Comparative analysis of vertical double plate versus clavicle hook plate for unstable distal clavicle fractures.
Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
To compare the clinical efficacy of vertical double-plate fixation (combining a distal clavicle locking plate and a radial lateral plate) versus clavicular hook plate fixation for unstable distal clavicle fractures. A retrospective analysis was conducted on 37 patients with unstable distal clavicle fractures (Neer II/V) treated at our institution from May 2015 to May 2023. Twenty-one patients underwent open reduction and internal fixation with clavicular hook plates (16 Neer II, 5 Neer V), while 16 patients received vertical double-plate fixation (12 Neer II, 4 Neer V). Postoperative evaluations included: 1) radiographic assessment of fracture healing at 1, 2, 3, and 6 months; 2) Visual Analogue Scale (VAS) pain scores during passive shoulder mobilization at 1, 2, and 4 weeks; and 3) Constant-Murley shoulder function scores and complication rates (incision infection, nonunion, acromial osteolysis, impingement syndrome) at 3, 6 and 12 months. The clavicular hook plate group (mean age 47.96±17.01 years) and vertical double-plate group (mean age 49.47±15.33 years) showed comparable demographics. All patients achieved fracture union within 3-6 months, with no implant displacement. The vertical double-plate group demonstrated significantly lower VAS scores during early rehabilitation (4.6±1.09, 4.05±0.88, 2.8±1.0 vs. 7.25±1.16, 5.9±1.12, 4.75±0.71; P<0.05). At 3, 6 and 12 months, Constant-Murley scores were markedly higher in the vertical double-plate group (84.41±4.48, 92.25±2.47, 94.55 vs. 75.35±5.92, 83.4±3.87, 88.10±2.10; P<0.05). The clavicular hook plate group exhibited higher complication rates: 4 cases of impingement syndrome, 3 of acromial osteolysis, and 5 with limited shoulder mobility-all improving after implant removal. Both techniques effectively achieve fracture union for unstable distal clavicle fractures. However, vertical double-plate fixation offers superior pain control, facilitates earlier functional rehabilitation, improves shoulder functional recovery, and reduces postoperative complications, demonstrating enhanced clinical efficacy compared to hook plate fixation.
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