{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T16:39:17Z","timestamp":1780331957100,"version":"3.54.1"},"reference-count":46,"publisher":"Elsevier BV","issue":"4","license":[{"start":{"date-parts":[[2023,4,1]],"date-time":"2023-04-01T00:00:00Z","timestamp":1680307200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,4,1]],"date-time":"2023-04-01T00:00:00Z","timestamp":1680307200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","jshoulderelbow.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Shoulder and Elbow Surgery"],"published-print":{"date-parts":[[2023,4]]},"DOI":"10.1016\/j.jse.2022.11.008","type":"journal-article","created":{"date-parts":[[2022,12,16]],"date-time":"2022-12-16T11:40:23Z","timestamp":1671190823000},"page":"695-702","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":4,"title":["Biomechanical analysis of plating techniques for unstable lateral clavicle fractures with coracoclavicular ligament disruption (Neer type\u00a0IIB)"],"prefix":"10.1016","volume":"32","author":[{"given":"Olivia I.","family":"Jo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7674-4522","authenticated-orcid":false,"given":"Mitchell","family":"Almond","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1936-7075","authenticated-orcid":false,"given":"Harshi S.","family":"Rupansinghe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David C.","family":"Ackland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4920-8518","authenticated-orcid":false,"given":"Lukas","family":"Ernstbrunner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3779-3545","authenticated-orcid":false,"given":"Eugene T.","family":"Ek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jse.2022.11.008_bib1","article-title":"Dual versus single-plate fixation of midshaft clavicular fractures: a retrospective comparative study","volume":"5","author":"Allis","year":"2020","journal-title":"JB JS Open Access"},{"key":"10.1016\/j.jse.2022.11.008_bib2","doi-asserted-by":"crossref","first-page":"3344","DOI":"10.1007\/s11999-011-2009-5","article-title":"Precontoured superior locked plating of distal clavicle fractures: a new strategy","volume":"469","author":"Andersen","year":"2011","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.jse.2022.11.008_bib3","doi-asserted-by":"crossref","first-page":"1248","DOI":"10.1016\/j.injury.2016.02.005","article-title":"Complications associated with operative fixation of acute midshaft clavicle fractures","volume":"47","author":"Asadollahi","year":"2016","journal-title":"Injury"},{"key":"10.1016\/j.jse.2022.11.008_bib4","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1186\/s13018-020-01771-x","article-title":"Single versus dual orthogonal plating for comminuted midshaft clavicle fractures: a biomechanics study","volume":"15","author":"Boyce","year":"2020","journal-title":"J Orthop Surg Res"},{"key":"10.1016\/j.jse.2022.11.008_bib5","doi-asserted-by":"crossref","first-page":"e22","DOI":"10.1016\/j.jse.2008.05.042","article-title":"Failure of superior locking clavicle plate by axial pull-out of the lateral screws: a report of four cases","volume":"18","author":"Brouwer","year":"2009","journal-title":"J Shoulder Elbow Surg"},{"key":"10.1016\/j.jse.2022.11.008_bib6","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.1302\/0301-620X.84B8.0841156","article-title":"Treatment of malignant bone tumours by extracorporeally irradiated autograft-prosthetic composite arthroplasty","volume":"84","author":"Chen","year":"2002","journal-title":"J Bone Joint Surg Br"},{"key":"10.1016\/j.jse.2022.11.008_bib7","first-page":"72","article-title":"Surgical treatment for distal clavicle fracture with coracoclavicular ligament disruption","volume":"52","author":"Chen","year":"2002","journal-title":"J Trauma"},{"key":"10.1016\/j.jse.2022.11.008_bib8","doi-asserted-by":"crossref","first-page":"329","DOI":"10.2174\/1874325001307010329","article-title":"Fractures of the clavicle: an overview","volume":"7","author":"Donnelly","year":"2013","journal-title":"Open Orthop J"},{"key":"10.1016\/j.jse.2022.11.008_bib9","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/0020-1383(92)90125-C","article-title":"Fractures of the distal clavicle: a case for fixation","volume":"23","author":"Edwards","year":"1992","journal-title":"Injury"},{"key":"10.1016\/j.jse.2022.11.008_bib10","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1007\/s00402-017-2645-7","article-title":"Comparative analysis of locking plate versus hook plate osteosynthesis of Neer type IIB lateral clavicle fractures","volume":"137","author":"Erdle","year":"2017","journal-title":"Arch Orthop Trauma Surg"},{"key":"10.1016\/j.jse.2022.11.008_bib11","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1016\/S0021-9290(05)80002-8","article-title":"The role of fixator frame stiffness in the control of fracture healing. An experimental study","volume":"26","author":"Goodship","year":"1993","journal-title":"J Biomech"},{"key":"10.1016\/j.jse.2022.11.008_bib12","first-page":"145","article-title":"Surgical treatment of lateral clavicular fracture with the \"clavicular hooked plate\"","volume":"87","author":"Hackenbruch","year":"1994","journal-title":"Z Unfallchir Versicherungsmed"},{"key":"10.1016\/j.jse.2022.11.008_bib13","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1016\/j.injury.2008.07.021","article-title":"Stabilisation of vertical unstable distal clavicular fractures (Neer 2b) using locking T-plates and suture anchors","volume":"40","author":"Herrmann","year":"2009","journal-title":"Injury"},{"key":"10.1016\/j.jse.2022.11.008_bib14","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1302\/0301-620X.79B4.0790537","article-title":"Closed treatment of displaced middle-third fractures of the clavicle gives poor results","volume":"79","author":"Hill","year":"1997","journal-title":"J Bone Joint Surg Br"},{"key":"10.1016\/j.jse.2022.11.008_bib15","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.clinbiomech.2019.07.001","article-title":"Forces acting on the clavicle during shoulder abduction, forward humeral flexion and activities of daily living","volume":"69","author":"Hoogervorst","year":"2019","journal-title":"Clin Biomech (Bristol, Avon)"},{"key":"10.1016\/j.jse.2022.11.008_bib16","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1016\/j.medengphy.2016.06.021","article-title":"Conceptual finite element study for comparison among superior, anterior, and spiral clavicle plate fixations for midshaft clavicle fracture","volume":"38","author":"Huang","year":"2016","journal-title":"Med Eng Phys"},{"key":"10.1016\/j.jse.2022.11.008_bib17","first-page":"522","article-title":"Treatment of distal clavicle fracture using Kirschner wires and tension-band wires","volume":"51","author":"Kao","year":"2001","journal-title":"J Trauma"},{"key":"10.1016\/j.jse.2022.11.008_bib18","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1016\/j.jse.2009.11.056","article-title":"Results of surgical treatment for unstable distal clavicular fractures","volume":"19","author":"Klein","year":"2010","journal-title":"J Shoulder Elbow Surg"},{"key":"10.1016\/j.jse.2022.11.008_bib19","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1097\/00005131-199004020-00002","article-title":"Type II distal clavicle fractures: a retrospective review of surgical treatment","volume":"4","author":"Kona","year":"1990","journal-title":"J Orthop Trauma"},{"key":"10.1016\/j.jse.2022.11.008_bib20","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/j.jseint.2021.08.003","article-title":"Fixation of distal clavicle fractures with coracoclavicular instability: a comparative biomechanical study in human cadavers","volume":"6","author":"Laux","year":"2022","journal-title":"JSES Int"},{"key":"10.1016\/j.jse.2022.11.008_bib21","doi-asserted-by":"crossref","first-page":"2090","DOI":"10.1016\/j.jse.2020.11.028","article-title":"Stand-alone coracoclavicular suture repair achieves very good results in unstable distal clavicle fractures at a minimum follow-up of 1 year","volume":"30","author":"Laux","year":"2021","journal-title":"J Shoulder Elbow Surg"},{"key":"10.1016\/j.jse.2022.11.008_bib22","doi-asserted-by":"crossref","first-page":"90","DOI":"10.2519\/jospt.2009.2808","article-title":"The association of scapular kinematics and glenohumeral joint pathologies","volume":"39","author":"Ludewig","year":"2009","journal-title":"J Orthop Sports Phys Ther"},{"key":"10.1016\/j.jse.2022.11.008_bib23","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1016\/j.arthro.2013.02.024","article-title":"Addition of a suture anchor for coracoclavicular fixation to a superior locking plate improves stability of type IIB distal clavicle fractures","volume":"29","author":"Madsen","year":"2013","journal-title":"Arthroscopy"},{"key":"10.1016\/j.jse.2022.11.008_bib24","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1016\/j.arthro.2010.02.009","article-title":"Biomechanical evaluation of arthroscopic rotator cuff repairs over time","volume":"26","author":"Mazzocca","year":"2010","journal-title":"Arthroscopy"},{"key":"10.1016\/j.jse.2022.11.008_bib25","doi-asserted-by":"crossref","first-page":"675","DOI":"10.2106\/JBJS.J.01364","article-title":"Operative versus nonoperative care of displaced midshaft clavicular fractures: a meta-analysis of randomized clinical trials","volume":"94","author":"McKee","year":"2012","journal-title":"J Bone Joint Surg Am"},{"key":"10.1016\/j.jse.2022.11.008_bib26","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/j.injury.2005.10.017","article-title":"Clavicular hook plate for lateral end fractures: a prospective study","volume":"37","author":"Meda","year":"2006","journal-title":"Injury"},{"key":"10.1016\/j.jse.2022.11.008_bib27","doi-asserted-by":"crossref","first-page":"613","DOI":"10.2106\/JBJS.N.00449","article-title":"Operative treatment of dislocated midshaft clavicular fractures: plate or intramedullary nail fixation? A randomized controlled trial","volume":"97","author":"van der Meijden","year":"2015","journal-title":"J Bone Joint Surg Am"},{"key":"10.1016\/j.jse.2022.11.008_bib28","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1097\/00003086-196805000-00007","article-title":"Fractures of the distal third of the clavicle","volume":"58","author":"Neer","year":"1968","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.jse.2022.11.008_bib29","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1097\/00005373-196303000-00001","article-title":"Fracture of the distal clavicle with detachment of the coracoclavicular ligaments in adults","volume":"3","author":"Neer","year":"1963","journal-title":"J Trauma"},{"key":"10.1016\/j.jse.2022.11.008_bib30","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1007\/s00402-010-1196-y","article-title":"Treatment of distal clavicle fracture: a systematic review of treatment modalities in 425 fractures","volume":"131","author":"Oh","year":"2011","journal-title":"Arch Orthop Trauma Surg"},{"key":"10.1016\/j.jse.2022.11.008_bib31","doi-asserted-by":"crossref","first-page":"1655","DOI":"10.1007\/s00402-015-2329-0","article-title":"Dual mini-fragment plating for midshaft clavicle fractures: a clinical and biomechanical investigation","volume":"135","author":"Prasarn","year":"2015","journal-title":"Arch Orthop Trauma Surg"},{"key":"10.1016\/j.jse.2022.11.008_bib32","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1302\/0301-620X.80B3.0800476","article-title":"Fractures of the clavicle in the adult. Epidemiology and classification","volume":"80","author":"Robinson","year":"1998","journal-title":"J Bone Joint Surg Br"},{"key":"10.1016\/j.jse.2022.11.008_bib33","doi-asserted-by":"crossref","first-page":"778","DOI":"10.2106\/00004623-200404000-00016","article-title":"Primary nonoperative treatment of displaced lateral fractures of the clavicle","volume":"86","author":"Robinson","year":"2004","journal-title":"J Bone Joint Surg Am"},{"key":"10.1016\/j.jse.2022.11.008_bib34","doi-asserted-by":"crossref","first-page":"e594","DOI":"10.1016\/j.jse.2020.12.026","article-title":"Does dual plating clavicle fractures increase the risk of refracture after hardware removal? A biomechanical investigation","volume":"30","author":"Ruzbarsky","year":"2021","journal-title":"J Shoulder Elbow Surg"},{"key":"10.1016\/j.jse.2022.11.008_bib35","doi-asserted-by":"crossref","first-page":"S34","DOI":"10.1016\/j.injury.2018.11.016","article-title":"Treatment of distal clavicle nonunion with and without bone grafting","volume":"49","author":"Santolini","year":"2018","journal-title":"Injury"},{"key":"10.1016\/j.jse.2022.11.008_bib36","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1016\/j.orthres.2005.03.005","article-title":"The course of bone healing is influenced by the initial shear fixation stability","volume":"23","author":"Schell","year":"2005","journal-title":"J Orthop Res"},{"key":"10.1016\/j.jse.2022.11.008_bib37","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1007\/s00402-013-1737-2","article-title":"Surgical treatment of vertically unstable lateral clavicle fractures (Neer 2b) with locked plate fixation and coracoclavicular ligament reconstruction","volume":"133","author":"Schliemann","year":"2013","journal-title":"Arch Orthop Trauma Surg"},{"key":"10.1016\/j.jse.2022.11.008_bib38","doi-asserted-by":"crossref","first-page":"5651","DOI":"10.3390\/app10165651","article-title":"A biomechanical study of various fixation strategies for the treatment of clavicle fractures using three-dimensional upper-body musculoskeletal finite element models","volume":"10","author":"Shih","year":"2020","journal-title":"Appl Sci"},{"key":"10.1016\/j.jse.2022.11.008_bib39","first-page":"107","article-title":"Comparison of 2 plating techniques for lateral clavicle fractures, using a new standardized biomechanical testing setup","volume":"16","author":"Suter","year":"2017","journal-title":"J Appl Biomater Funct Mater"},{"key":"10.1016\/j.jse.2022.11.008_bib40","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1186\/s13018-016-0435-5","article-title":"A biomechanical comparison study of a modern fibular nail and distal fibular locking plate in AO\/OTA 44C2 ankle fractures","volume":"11","author":"Switaj","year":"2016","journal-title":"J Orthop Surg Res"},{"key":"10.1016\/j.jse.2022.11.008_bib41","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijscr.2021.106411","article-title":"Peri-implant distal clavicle fracture: case report (overlaying plate fixation: Solution for peri-implant clavicle fractures)","volume":"87","author":"Vieira Lima","year":"2021","journal-title":"Int J Surg Case Rep"},{"key":"10.1016\/j.jse.2022.11.008_bib42","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1007\/s00402-010-1240-y","article-title":"Locking plates have increased torsional stiffness compared to standard plates in a segmental defect model of clavicle fracture","volume":"131","author":"Will","year":"2011","journal-title":"Arch Orthop Trauma Surg"},{"key":"10.1016\/j.jse.2022.11.008_bib43","doi-asserted-by":"crossref","first-page":"982","DOI":"10.1016\/j.jse.2018.11.041","article-title":"A biomechanical comparison of new techniques for distal clavicular fracture repair versus locked plating","volume":"28","author":"Yagnik","year":"2019","journal-title":"J Shoulder Elbow Surg"},{"key":"10.1016\/j.jse.2022.11.008_bib44","doi-asserted-by":"crossref","first-page":"1461","DOI":"10.1007\/s00264-014-2340-z","article-title":"Comparison of the efficacy of a distal clavicular locking plate versus a clavicular hook plate in the treatment of unstable distal clavicle fractures and a systematic literature review","volume":"38","author":"Zhang","year":"2014","journal-title":"Int Orthop"},{"key":"10.1016\/j.jse.2022.11.008_bib45","doi-asserted-by":"crossref","first-page":"2678","DOI":"10.1177\/0363546519865251","article-title":"Low-profile dual small plate fixation is biomechanically similar to larger superior or anteroinferior single plate fixation of midshaft clavicle fractures","volume":"47","author":"Ziegler","year":"2019","journal-title":"Am J Sports Med"},{"key":"10.1016\/j.jse.2022.11.008_bib46","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1097\/01.bot.0000172287.44278.ef","article-title":"Treatment of acute midshaft clavicle fractures: systematic review of 2144 fractures: on behalf of the Evidence-Based Orthopaedic Trauma Working Group","volume":"19","author":"Zlowodzki","year":"2005","journal-title":"J Orthop Trauma"}],"container-title":["Journal of Shoulder and Elbow Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1058274622008801?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1058274622008801?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:56:33Z","timestamp":1761008193000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1058274622008801"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4]]},"references-count":46,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023,4]]}},"alternative-id":["S1058274622008801"],"URL":"https:\/\/doi.org\/10.1016\/j.jse.2022.11.008","relation":{},"ISSN":["1058-2746"],"issn-type":[{"value":"1058-2746","type":"print"}],"subject":[],"published":{"date-parts":[[2023,4]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Biomechanical analysis of plating techniques for unstable lateral clavicle fractures with coracoclavicular ligament disruption (Neer type\u00a0IIB)","name":"articletitle","label":"Article Title"},{"value":"Journal of Shoulder and Elbow Surgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jse.2022.11.008","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2022 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.","name":"copyright","label":"Copyright"}]}}