{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T13:42:14Z","timestamp":1777124534251,"version":"3.51.4"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T00:00:00Z","timestamp":1763942400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T00:00:00Z","timestamp":1766966400000},"content-version":"vor","delay-in-days":35,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["81400859"],"award-info":[{"award-number":["81400859"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>To compare the clinical efficacy of vertical double-plate fixation (combining a distal clavicle locking plate and a radial lateral plate) versus clavicular hook plate fixation for unstable distal clavicle fractures. A retrospective analysis was conducted on 37 patients with unstable distal clavicle fractures (Neer II\/V) treated at our institution from May 2015 to May 2023. Twenty-one patients underwent open reduction and internal fixation with clavicular hook plates (16 Neer II, 5 Neer V), while 16 patients received vertical double-plate fixation (12 Neer II, 4 Neer V). Postoperative evaluations included: 1) radiographic assessment of fracture healing at 1, 2, 3, and 6 months; 2) Visual Analogue Scale (VAS) pain scores during passive shoulder mobilization at 1, 2, and 4 weeks; and 3) Constant-Murley shoulder function scores and complication rates (incision infection, nonunion, acromial osteolysis, impingement syndrome) at 3, 6 and 12 months. The clavicular hook plate group (mean age 47.96\u00b117.01 years) and vertical double-plate group (mean age 49.47\u00b115.33 years) showed comparable demographics. All patients achieved fracture union within 3\u20136 months, with no implant displacement. The vertical double-plate group demonstrated significantly lower VAS scores during early rehabilitation (4.6\u00b11.09, 4.05\u00b10.88, 2.8\u00b11.0 vs. 7.25\u00b11.16, 5.9\u00b11.12, 4.75\u00b10.71; P&lt;0.05). At 3, 6 and 12 months, Constant-Murley scores were markedly higher in the vertical double-plate group (84.41\u00b14.48, 92.25\u00b12.47, 94.55 vs. 75.35\u00b15.92, 83.4\u00b13.87, 88.10\u00b12.10; P&lt;0.05). The clavicular hook plate group exhibited higher complication rates: 4 cases of impingement syndrome, 3 of acromial osteolysis, and 5 with limited shoulder mobility\u2014all improving after implant removal. Both techniques effectively achieve fracture union for unstable distal clavicle fractures. However, vertical double-plate fixation offers superior pain control, facilitates earlier functional rehabilitation, improves shoulder functional recovery, and reduces postoperative complications, demonstrating enhanced clinical efficacy compared to hook plate fixation.<\/jats:p>","DOI":"10.1038\/s41598-025-28875-w","type":"journal-article","created":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T16:26:25Z","timestamp":1764001585000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative analysis of vertical double plate versus clavicle hook plate for unstable distal clavicle fractures"],"prefix":"10.1038","volume":"15","author":[{"given":"Songlin","family":"Li","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinkang","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Han","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junjie","family":"Du","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yufei","family":"chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,11,24]]},"reference":[{"issue":"3","key":"28875_CR1","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1016\/j.jse.2011.08.053","volume":"21","author":"OA Van der Meijden","year":"2012","unstructured":"Van der Meijden, O. A., Gaskill, T. R. & Millett, P. J. Treatment of clavicle fractures: current concepts review. J. Shoulder Elb. Surg. 21 (3), 423\u2013429 (2012).","journal-title":"J. Shoulder Elb. Surg."},{"issue":"4","key":"28875_CR2","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1007\/s00402-010-1196-y","volume":"131","author":"JH Oh","year":"2011","unstructured":"Oh, J. H., Kim, S. H., Lee, J. H., Shin, S. H. & Gong, H. S. Treatment of distal clavicle fracture: a systematic review of treatment modalities in 425 fractures. Arch. Orthop. Trauma. Surg. 131 (4), 525\u2013533 (2011).","journal-title":"Arch. Orthop. Trauma. Surg."},{"key":"28875_CR3","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1097\/00003086-196805000-00007","volume":"58","author":"CN Neer","year":"1968","unstructured":"Neer, C. N. Fractures of the distal third of the clavicle. Clin. Orthop. Relat. Res. 58, 43\u201350 (1968).","journal-title":"Clin. Orthop. Relat. Res."},{"key":"28875_CR4","first-page":"221","volume":"17","author":"L Yue","year":"2025","unstructured":"Yue, L., Huang, C., Zhang, J., Wang, Z. & Wang, S. Haolin sun. treatment strategies for distal clavicle fractures: a narrative review. Orthop. Res. Rev. 17, 221\u2013227 (2025).","journal-title":"Orthop. Res. Rev."},{"issue":"1","key":"28875_CR5","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1186\/s13018-022-03108-2","volume":"17","author":"A Panagopoulos","year":"2022","unstructured":"Panagopoulos, A., Tatani, K. S. I., Triantafyllopoulos, I. K. & John Lakoumentas. What is the optimal surgical treatment for Neer type IIB (IIC) distal clavicle fractures? A systematic review and meta-analysis. J. Orthop. Surg. Res. 17 (1), 215 (2022).","journal-title":"J. Orthop. Surg. Res."},{"issue":"1","key":"28875_CR6","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1007\/s00402-024-05731-6","volume":"145","author":"TY Tsai","year":"2025","unstructured":"Tsai, T. Y., Hsu, S. L., Hsu, C. H., Liao, C. Y. & Lu, Y. D. Distal augmentation in unstable distal clavicle fractures: a retrospective cohort study of 101 cases. Arch. Orthop. Trauma. Surg. 145 (1), 111 (2025).","journal-title":"Arch. Orthop. Trauma. Surg."},{"issue":"2","key":"28875_CR7","first-page":"534","volume":"51","author":"J Sophie","year":"2021","unstructured":"Sophie, J. et al. Outcomes, Union Rate, and Complications After Operative and Nonoperative Treatments of Neer Type II Distal Clavicle Fractures: A Systematic Review and Meta-analysis of 2284 Patients. Am. J. Sport. Med. 51(2), 534\u2013544 (2021).","journal-title":"Am. J. Sport. Med."},{"issue":"1","key":"28875_CR8","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1007\/s00402-021-04287-z","volume":"143","author":"S Shahbaz","year":"2022","unstructured":"Shahbaz, S. et al. A systematic review and meta-analysis comparing the use of Hook plates and superior plates in the treatment of displaced distal clavicle fractures. Arch. Orthop. Trauma. Surg. 143 (1), 329\u2013352 (2022).","journal-title":"Arch. Orthop. Trauma. Surg."},{"issue":"2","key":"28875_CR9","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1016\/j.jcot.2014.05.007","volume":"5","author":"B Sambandam","year":"2014","unstructured":"Sambandam, B., Gupta, R., Kumar, S. & Maini, L. Fracture of distal end clavicle: A review. J. Clin. Orthop. Trauma. 5 (2), 65\u201373 (2014).","journal-title":"J. Clin. Orthop. Trauma."},{"issue":"5","key":"28875_CR10","doi-asserted-by":"publisher","first-page":"853","DOI":"10.1016\/j.otsr.2019.03.012","volume":"105","author":"A Singh","year":"2019","unstructured":"Singh, A., Schultzel, M., Fleming, J. F. & Navarro, R. A. Complications after surgical treatment of distal clavicle fractures. Orthop. Traumatol. Surg. 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M., Schnetzke, M., Gr\u00fctzner, P. A. & Nolte, P. C. Hook plate fixation of Neer type II distal clavicle fractures results in satisfactory patient-reported outcomes but complications and revisions are high. BMC Musculoskelet. Disord. 24 (1), 850 (2023).","journal-title":"BMC Musculoskelet. Disord"},{"issue":"2","key":"28875_CR16","first-page":"223","volume":"85","author":"H Takahashi","year":"2023","unstructured":"Takahashi, H., Takegami, Y., Tokutake, K., Katayama, Y. & Imagama, S. Hook plate fixation versus locking plate fixation for distal clavicle fracture: a multicenter propensity score-matched study. Nagoya J. Med. Sci. 85 (2), 223\u2013232 (2023).","journal-title":"Nagoya J. Med. Sci."},{"issue":"1","key":"28875_CR17","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1007\/s00068-007-9155-1","volume":"33","author":"DA Rikli","year":"2007","unstructured":"Rikli, D. A., Businger, A. & Babst, R. Dorsal Double-Plate fixation of the distal radius. Eur. J. Trauma. Emerg. 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Surg."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-28875-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-28875-w","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-28875-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T13:05:15Z","timestamp":1777122315000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-28875-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,24]]},"references-count":21,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["28875"],"URL":"https:\/\/doi.org\/10.1038\/s41598-025-28875-w","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,24]]},"assertion":[{"value":"4 April 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 November 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 November 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"This retrospective study adhered to the ethical principles outlined in the Declaration of Helsinki. Written informed consent was obtained from all participants or their legally authorized representatives for participation and publication of potentially identifiable information\/images in this open-access article, and the study protocol was approved by the Institutional Ethics Committee of Air Force Medical Center (approval NO. 2023-11-PJ01).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical considerations"}}],"article-number":"45223"}}