Abstract

Aim: Distal clavicle fractures account for 15% of all clavicle fractures. Neer type II lateral end fractures are associated with non-union rates of 30%. Further, fixations by way of hook plates seem to have proved successful. We report our experience using the hook plate in the treatment of distal clavicle fractures. Methods: Twenty four patients with distal clavicle fractures were operated on and had an AO hook plate (Synthes®) implanted. 20 men and 4 women were retrospectively reviewed. The average age at time of surgery was 35 (range 18-74). All the patients presented with a Neer type II distal fracture. The average follow-up was 20 months (range 10 - 26), and the patients were radiologically and clinically evaluated during this period of time. The Constant-Murley score was used to measure shoulder movement, strength and pain. The patient’s ability to carry out his or her daily-life activities was measured with both the Constant-Murley score and the Oxford Test. Results: Twenty four patients achieved clinical and radiologic union and one patient suffered from failure of fixation. All the plates were removed. In the last visit, the mean Constant-Murley score and the mean Oxford score were 85 and 42, respectively, and seven patients presented with osteolysis. All patients were able to return to their preinjury activity level. Conclusion: Hook plate fixations of distal clavicle fractures offer good functional results with the shortcoming of plate removal after bone fusion is achieved. Osteolysis is a common complication associated with keeping the implant for over 6 months and it did not result in poor functional outcomes.