TightRope versus hook plate fixation for Neer type IIB distal clavicular fractures

Background: Neer type IIB distal clavicular fractures are inherently unstable as they disrupt the integrity of the conoid ligament. The purpose of this study was to compare the short-term efficacy of TightRope and hook plate in the treatment of distal clavicular fractures. Methods A retrospective case control study was conducted to analyze the clinical data of 39 patients with distal clavicular fractures admitted to Sir Run Run Hospital, Nanjing Medical University from January 2018 to June 2022. Clinical and radiological results were assessed using American Shoulder and Elbow Surgeons (ASES) score, Visual Analogue Scale (VAS) and the Constant score. Results All patients were followed up for a period of 12 to 24 months, with an average of 16 months. The smaller length of skin incision, less intraoperative blood loss and shorter operative time were detected in the TightRope fixation group than in those of the clavicular hook plate group. ( P  < 0.01, respectively). Furthermore, the constant score, ASES score and VAS score were significantly improved in the Tightrope technique group than those of the hook plate group ( P  < 0.01, respectively). No serious postoperative complications such as loosening of internal fixation, loss of reduction or recurrence of fracture were found in either group. Conclusion For distal clavicular fractures, TightRope can obtain good clinical outcomes and have obvious advantages in operation time, period for union, lower incidence of shoulder pain and better functional recovery than hook plate.