Short-term effects of coracoclavicular ligament reconstruction combined with anatomical locking plate internal fixation in the treatment of old Neer type Ⅱb distal clavicular fractures
Objective To explore the short-term effects of coracoclavicular ligament reconstruction com-bined with anatomical locking plate internal fixation in managing old Neer type Ⅱb distal clavicular fractures.Methods Clinical data of91 patients with old Neer type Ⅱb distal clavicular fractures admitted to the Department of Orthopedics of Central Theater Command General Hospital from Mar.2017 to Apr.2022 were retrospectively an-alyzed.There were 51 males and 40 females aged 23-68 (mean 49.7) years.The body mass index was 19.3-28.6 ( mean 23.6) kg/m2 and time from injury to surgery was 24-36 (31.1) d.The injury causes were road traffic acci-dents in 54 cases,falls in 25 and others in 12,with 27 cases combined with other injuries.Patients were divided into group A(n=47,treated by coracoclavicular ligament reconstruction and anatomical locking plate fixation) and group B(n=44,treated by anatomical locking plate fixation alone).The intraoperative condition,recovery indicators after operation,Constant-Murley scores,VAS scores and postoperative complications were recorded and compared between two groups.Results Compared with group B,group A showed much longer operation time(min,69.4±5.2 vs.60.4±6.3) and more intraoperative bleeding (mL,67.4±5.3 vs.44.9±4.1),but much quicker bone healing (week,13.9±2.5 vs.16.7±2.9),shorter length of hospitalization (d,7.5±1.9 vs.10.3±2.2),and less in-crease of the coracoclavicular space (13.9％±3.9％ vs.17.9％±2.7％,all P<0.05).Postoperatively,the VAS scores were significantly lower in group A than those in group B (2.7±0.5 vs.1.5±0.3 at 3 months and 3.8±0.6 vs.2.0±0.4 at 6 months) and the Constant-Murley scores were much higher (75.8±6.2 vs.67.4±5.9 at 3 months and 91.7±6.5 vs.84.7±5.2 at 6 months,all P<0.05).There was no statistically significant difference in the incidence of complications between groups A and B (2.1％ vs.11.4％,P>0.05).Conclusion Coraco-clavicular ligament reconstruction combined with anatomical locking plate internal fixation for patients with old Neer type Ⅱb distal clavicular fractures can accelerate bone healing,reduce the risk of coracoclavicular space increase,and also alleviate postoperative pain and improve the shoulder joint function.
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