Correlation Between Treatment Using a Wolter Clavicular Plate and a Best Acromioclavicular Plate for a Fracture of the Distal End of the Cla vicle

Abstract

[Propose] We studied the problems of fixation of fractures of the distal ends of the clavicles by using the "Wolter clavicular plate" and "Best acromioclavicular plate".
[Meterials] Fifteen fractures of Neer type 2 distal clavicle fractures were treated by plates. Ten patients were treated by "Wolter clavicular plate" and 5 patients were treated by "Best acromioclavicular plate".
[Results]The active elevation in the affected shoulder joint acquired over 100° after removal of the plate. All the patients had neither pain nor muscle contracture after removing the plate. A good union was obtained in all of the cases, but a wire had to be used to fix the plate instead of a screw because the Wolter clavicular plate did not fit the clavicle of one patient. The hook holes of both plates expanded in patients when they raised their upper arms over 135°. Those patients who used a "Wolter clavicular plate" had superior scores to those who used a "Best acromioclavicular plate" on the JOA score.
[Conclusions] The Wolter clavicular plate and the Best acromioclavicular plate could maintain the anatomical repositioning of an unstable distal clavicle fracture and the former was superior to the latter on the JOA score after removing the plates. But the affected shoulder joint could not be elavated more than 90° before removal of the plate. The plate should be removed as soon as the union is completed.