[Application study of a novel locking anatomical plate in treatment of Neer type Ⅱb and type Ⅴ distal clavicle fractures].

OBJECTIVE

To evaluate the feasibility and effectiveness of a novel locking anatomical plate designed for the acromial end of the clavicle (hereinafter referred to as the "novel locking plate") in the treatment of Neer type Ⅱb and type Ⅴ distal clavicle fractures.

METHODS

Between February 2024 and January 2025, a total of 12 patients with Neer type Ⅱb and type Ⅴ distal clavicle fractures resulting from trauma were treated using the novel locking plate. The cohort comprised 7 males and 5 females, with ages ranging from 22 to 65 years (mean, 49.6 years). According to the Neer fracture classification system, 9 cases were classified as type Ⅱb and 3 cases as type Ⅴ. The interval from injury to operation ranged from 2 to 6 days (mean, 3.9 days). After achieving anatomical reduction of the fracture, the novel locking plate was applied for internal fixation, accompanied by anatomical reconstruction of the coracoclavicular ligament. The operation time, intraoperative blood loss, and incision healing were meticulously documented. During follow-up, the radiographic examinations were taken to assess fracture healing, and the shoulder joint function was evaluated using the Constant-Murley score criteria.

RESULTS

All 12 operations were completed. The operation time ranged from 55 to 90 minutes (mean, 74 minutes), and intraoperative blood loss ranged from 50 to 100 mL (mean, 85 mL). All incisions healed by first intention. All patients were followed up 6-18 months (mean, 11.6 months). At last follow-up, the radiographic examination demonstrated that all fractures had achieved bony union; the Constant-Murley score ranged from 92 to 96 (mean, 94.3), all rated as excellent.

CONCLUSION

For Neer type Ⅱb and type Ⅴ distal clavicle fractures, the combination of the novel locking plate fixation and anatomical reconstruction of the coracoclavicular ligament provides reliable internal fixation, promotes fracture healing, and yields highly satisfactory effectiveness.