Reconstruction des ligaments coraco-claviculaires par ancres ou plaque crochet dans le traitement des fractures distales de la clavicule

Summary Introduction Comparison of clinical efficacies between coracoclavicular ligament reconstruction using autologous gracilis tendon with suture anchor and clavicular hook plate for the treatment of acute Neer type II distal clavicle fracture. Hypothesis Both coracoclavicular reconstruction with autologous gracilis tendon and clavicular hook plate could achieve satisfactory results for treating acute Neer type II distal clavicle fracture. Methods Acute Neer type II distal clavicle fracture patients enrolled in this prospective randomized study were divided into the coracoclavicular ligament reconstruction group (using autologous gracilis tendon and suture anchor) and the hook plate group. Clinical outcomes were evaluated by shoulder X-ray, forward flexion, abduction and external rotation angle, Constant-Murley shoulder score and pain visual analogue scale (VAS) at each follow-up for up to 24 months. Results The current study enrolled a total of forty-two acute Neer type II distal clavicle fracture patients attended our hospital from March 2010 to December 2013. All patients had achieved complete healing and followed up for an average of 26 months (range, 24–38 months). At 3-month and 6-month follow-ups, Constant-Murley score in the ligament reconstruction group was significantly higher (93.8 ± 2.6 vs 88.7 ± 8.7; 95.9 ± 2.7 vs 93.0 ± 7.0, P P Discussion Reconstruction with autologous gracilis tendon improved VAS pain score in early post-operation follow-up; while Constant-Murley score and VAS score were significantly improved in the hook plate group after the implant was removed. These suggested that both coracoclavicular reconstruction with autologous gracilis tendon and clavicular hook plate could achieve satisfactory results. Level of evidence Level II, low-powered prospective randomized trial.