Application of a NOW-J Plate for Treatment of Distal Clavicle Fractures

Abstract

It is sometimes difficult to achieve rigid internal fixation and early shoulder ROM recovery in patients with distal clavicle fracture. We have developed an anatomical locking distal clavicle plate (NOW-J) through which a maximum of ten screws can be inserted to the distal fragment. We investigated the clinical results of obtained with the NOW-J plate for treatment of distal clavicle fractures. Ten patients (8 men and 2 women, mean age 54.9 years) were included in the study. The fracture types according to the Craig classification were Type I in 3 cases, Type IIA in 3 cases, Type IIB in 2 cases, and Type V in 2 cases. All the patients started postoperative rehabilitation on the day after the surgery. Bone union without displacement was achieved in all patients within 3 months after surgery. Shoulder elevation of 150° was achieved within 3 weeks after surgery in 9 cases. We conclude that the NOW-J is a useful plate for treatment of distal clavicle fracture because of the rigid fixation it provides. Further study is needed to clarify whether the NOW-J can be applied to more unstable fractures, distal comminuted fractures, and osteoporotic fractures.