Introduction
We used a new internal fixative implant, the AO clavicle hook-plate, for treatment of unstable fractures of the distal clavicle.
This study describes the operative procedure and the clinical results obtained, as well as discussion of the advantages and
problems encountered.
Patients and methods
Fifteen consecutive patients with unstable fractures of the distal clavicle (Neer type II) were treated using AO clavicle
hook-plates. The average age of patients was 47 years and there were 13 males and 2 females. The mean follow-up period was
15.5 months. Plain radiographs of clavicles were used to assess bony union. Functional recovery of the shoulder joint was
assessed using the Constant–Murley scoring system.
Results
All fractures eventually achieved solid bony union within 4 months after surgery. Thirteen patients (87%) showed hook migration
into the acromion. Clinical results were excellent with a mean Constant–Murley score of 89 points at final follow-up.
Conclusion
AO clavicle hook-plates are useful fixative implants for unstable fractures of the distal clavicle. Static fixation was achieved
and physiotherapy can be started immediately after surgery. Early removal of the implant is recommended however because hooks
inserted under the acromion migrated into the bone in most cases.
Keywords Clavicle fracture - Hook plate - Distal clavicle - Complication