| Objective: To compare the therapeutic effects of Double- Endobutton and clavicular hook plate for the treatment of Neer typeⅡdistal clavicle fracture.Methods:38 patients of Neer typeⅡdistal clavicle fracture from January 2011 to December 2013 were admitted to our department case-control study.18 patients were treated with Double- Endobutton,and 20 patients were treated with clavicular hook plate.The difference between the two groups was not significant in preoperative evaluation of general information(gender,age, injured shoulder and time from injure to operation and comparability existed. Duration of operation, blood loss perioperation,hospitalization time, the cost of treatment, removing the implants(yes or no),and VAS(at postoperative 1 month,3 month,6 months and after remving the implants out)of the shoulder,s ASES(at postoperative 1 month,3 month,6 months and after remving the implants out) as well as complications were evaluated.All surgery were presided over by the same orthopedic surgeons to complete. All injured limbs were overhung with forearm straps for braking for 3-4 weeks. They all underwent early rehabilitation training according to the plan. The follow-up time was 12-24 months.Results: The average operative time, average blood loss and average curative costs were(42.86±6.90) minutes,(40.86±5.45) ml and(14094±1735.67)yuan in the CHP group and(60.73±5.21)minutes,(70.91±7.62)ml and(14094±1735.67)yuan in the Double-Endobutton group, showing statistical difference between these two groups(P<0.05). The former was better than the latter. The average hospitalization time was(10.18±2.64)day in the CHP group,and(10.07±2.87)day in the Double-Endobutton group. There was not statistically significant between the two groups.There were 13,13 and 6 patients in the CHP group feeling pain at postoperative 1 month,3 months and 6 months when they were resting,and 20,16 and 6 patients feeling pain when they were dynamic. There were 7,6 and 61 patients in the Double-Endobutton group feeling pain at postoperative 1 month,3 months and 6 months when they were resting,and 11,10 and 1 patients feeling pain when they were dynamic. The average static VAS scores were(0.705±0.772),(0.420±0.563) and(0.160±0.282) in the CHP group at postoperative 1, 3 and 6 months respectively,and( 0.117±0.186),( 0.078±0.126) and( 0.006±0.024) in the Double-Endobutton group. The dynamic VAS scores were(1.450± 0.942),(0.690±0.564) and(0.140±0.250) in the CHP group,and(0.361± 0.474),(0.172±0.270) and(0.011±0.047) in the Double-Endobutton group. There was statistically significant between the two groups. The latter was obviously superior to the former. The average ASES scores were(72.13±8.64),(82.50±7.13) and(91.07±5.2) in CHP group atpostoperative 1, 3 and 6 months respectively and(77.77±6.43),(88.09±6.93) and(96.43±6.13) in the Double-Endobutton group. There was statistically significant between the two groups. The latter was obviously superior to the former. The clavicular hook plate were required to be removed by the second operation. However this was not necessary in the Endobutton group. After the clavicular hook plate being removed, The average VAS scores were(0.020±0.089) in CHP group and(0.000±0.000) in the Double-Endobutton group, and the average ASES scores were(98.57±3.74) in CHP group and(99.21±2.31) in the Double-Endobutton group. There was not statistically significant between the two groups. There was not statistically significant in the occurrence of fracture, internal fixation breakage, loosening, and incision infection and complications in the two groups. The displacement of fracture occurred on one case in the Double-Endobutton group. The fracture healed over well after manual reduction and suspension.Conclusion: The near-term therapeutic effects of Double- Endobutton for the treatment of Neer typeⅡdistal clavicle fracture were better than clavicular hook plate,and no significant difference in long-term therapeutic effects. |
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