Objective To compare the efficacy between Kirschner wire and clavicular hook plate in the fixation of distal clavicle fractures in older children.Methods A retrospective analysis was conducted of the 28 pediatric patients with distal clavicle fracture who had undergone surgical treatment at Department of Pediatric Orthopedics,The Second General Hospital of Fuzhou from December 2014 to December 2023.There were 20 boys and 8 girls.Age:10.0(9.0,12.8)years old;22 left sides and 6 right sides;by the Craig modi-fied Neer classification:22 cases of type Ⅱ,5 cases of type Ⅳ,and 1 case of type Ⅴ.The patients were divid-ed into 2 groups based on their internal fixation methods.The Kirschner wire group of 12 cases were treated with open reduction and Kirschner wire fixation;the hook plate group of 16 cases were treated with open reduc-tion and clavicular hook plate fixation.Operation time,hospital stay,fracture healing time,incidence of com-plications,and scores at the final follow-up(the Constant-Murley shoulder function score,quick disabilities of the arm,shoulder,and hand(quickDASH)score,and visual analog scale(VAS)for aesthetic satisfaction)were recorded and compared between the 2 groups.Results There were no statistically significant differ-ences in the baseline data between the 2 groups,indicating comparability(P＞0.05).The postoperative follow-up period for the 28 patients was(14.8±6.5)months.The operation time in the Kirschner wire group[(34.3±12.1)min]was significantly shorter than that in the hook plate group[(49.4±16.8)min](P＜0.05),and the VAS score for aesthetic satisfaction at the final follow-up in the Kirschner wire group[(8.2±1.1)points]was significantly higher than that in the hook plate group[(6.2±2.6)points](P＜0.05).There were no statistically significant differences between the 2 groups in terms of fracture healing time,hospital stay,incidence of complications,or Constant-Murley score and quickDASH score at the final follow-up(P＞0.05).Conclusions For pediatric patients with distal clavicle fracture,both Kirschner wire fixation and clavicular hook plate fixation can achieve good functional outcomes.However,Kirschner wire fixation has ad-vantages of shorter operation time,higher postoperative aesthetic satisfaction,and no need of a secondary surgery for implant removal.
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