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Published in: Journal of Orthopaedic Surgery and Research 1/2012

Open Access 01-12-2012 | Research article

Hook plate fixation of acute displaced lateral clavicle fractures: mid-term results and a brief literature overview

Authors: Davut Tiren, Alexander JM van Bemmel, Dingeman J Swank, Frits M van der Linden

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2012

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Abstract

Background

The clavicle hook plate achieves like most other operative techniques, a high percentage of union and a low percentage of complications however concerns about long term complications still exist, particularly the involvement of the acromioclavicular joint.

Methods

To evaluate the results and long term effects in use of this plate we performed a retrospective analysis with a mean follow up of 65 months (5.4 years) of 28 consecutive patients with acute displaced lateral clavicle fractures, treated with the clavicle hook plate.

Results

Short term functional results in all patients were good to excellent. All but one patient had a united fracture (96%). Nine patients (32%) developed impingement symptoms and in 7 patients (25%) subacromial osteolysis was found. These findings resolved after plate removal. Twenty-four patients were re-evaluated at a mean follow-up period of 5.4 years. The Constant-Murley score was 97 and the DASH score was 3.5. Four patients (14%) developed acromioclavicular joint arthrosis of which one was symptomatic. Three patients (11%) had extra articular ossifications of which one was symptomatic. There was no relation between the impingement symptoms, subacromial osteolysis and development of acromioclavicular joint arthrosis or extra articular ossifications.

Conclusions

The clavicle hook plate is a good primary treatment option for the acute displaced lateral clavicle fracture with few complications. At mid term the results are excellent and no long term complications can be addressed to the use of the plate.
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Literature
1.
go back to reference Flinkkila T, Ristiniemi J, Hyvonen P, Hamalainen M: Surgical treatment of unstable fractures of the distal clavicle: a comparative study of Kirschner wire and clavicular hook plate fixation. Acta Orthop Scand. 2002, 73: 50-53. 10.1080/000164702317281404.CrossRefPubMed Flinkkila T, Ristiniemi J, Hyvonen P, Hamalainen M: Surgical treatment of unstable fractures of the distal clavicle: a comparative study of Kirschner wire and clavicular hook plate fixation. Acta Orthop Scand. 2002, 73: 50-53. 10.1080/000164702317281404.CrossRefPubMed
2.
go back to reference Lee YS, Lau MJ, Tseng YC, Chen WC, Kao HY, Wei JD: Comparison of the efficacy of hook plate versus tension band wire in the treatment of unstable fractures of the distal clavicle. Int Orthop. 2009, 33: 1401-1405. 10.1007/s00264-008-0696-7.PubMedCentralCrossRefPubMed Lee YS, Lau MJ, Tseng YC, Chen WC, Kao HY, Wei JD: Comparison of the efficacy of hook plate versus tension band wire in the treatment of unstable fractures of the distal clavicle. Int Orthop. 2009, 33: 1401-1405. 10.1007/s00264-008-0696-7.PubMedCentralCrossRefPubMed
3.
go back to reference Tambe AD, Motkur P, Qamar A, Drew S, Turner SM: Fractures of the distal third of the clavicle treated by hook plating. Int Orthop. 2006, 30: 7-10. 10.1007/s00264-005-0019-1.PubMedCentralCrossRefPubMed Tambe AD, Motkur P, Qamar A, Drew S, Turner SM: Fractures of the distal third of the clavicle treated by hook plating. Int Orthop. 2006, 30: 7-10. 10.1007/s00264-005-0019-1.PubMedCentralCrossRefPubMed
4.
go back to reference Bhangal KK, Evans SC, Gibbons E: Treatment of Displaced Lateral Clavicle Fractures with the AO Hook Plate. European Journal of Trauma. 2006, 5: 468-470.CrossRef Bhangal KK, Evans SC, Gibbons E: Treatment of Displaced Lateral Clavicle Fractures with the AO Hook Plate. European Journal of Trauma. 2006, 5: 468-470.CrossRef
5.
go back to reference Flinkkila T, Ristiniemi J, Lakovaara M, Hyvonen P, Leppilahti J: Hook-plate fixation of unstable lateral clavicle fractures: a report on 63 patients. Acta Orthop. 2006, 77: 644-649. 10.1080/17453670610012737.CrossRefPubMed Flinkkila T, Ristiniemi J, Lakovaara M, Hyvonen P, Leppilahti J: Hook-plate fixation of unstable lateral clavicle fractures: a report on 63 patients. Acta Orthop. 2006, 77: 644-649. 10.1080/17453670610012737.CrossRefPubMed
6.
go back to reference Haidar SG, Krishnan KM, Deshmukh SC: Hook plate fixation for type II fractures of the lateral end of the clavicle. J Shoulder Elbow Surg. 2006, 15: 419-423. 10.1016/j.jse.2005.11.012.CrossRefPubMed Haidar SG, Krishnan KM, Deshmukh SC: Hook plate fixation for type II fractures of the lateral end of the clavicle. J Shoulder Elbow Surg. 2006, 15: 419-423. 10.1016/j.jse.2005.11.012.CrossRefPubMed
7.
go back to reference Meda PV, Machani B, Sinopidis C, Braithwaite I, Brownson P, Frostick SP: Clavicular hook plate for lateral end fractures:- a prospective study. Injury. 2006, 37: 277-283. 10.1016/j.injury.2005.10.017.CrossRefPubMed Meda PV, Machani B, Sinopidis C, Braithwaite I, Brownson P, Frostick SP: Clavicular hook plate for lateral end fractures:- a prospective study. Injury. 2006, 37: 277-283. 10.1016/j.injury.2005.10.017.CrossRefPubMed
8.
go back to reference Muramatsu K, Shigetomi M, Matsunaga T, Murata Y, Taguchi T: Use of the AO hook-plate for treatment of unstable fractures of the distal clavicle. Arch Orthop Trauma Surg. 2007, 127: 191-194. 10.1007/s00402-006-0284-5.CrossRefPubMed Muramatsu K, Shigetomi M, Matsunaga T, Murata Y, Taguchi T: Use of the AO hook-plate for treatment of unstable fractures of the distal clavicle. Arch Orthop Trauma Surg. 2007, 127: 191-194. 10.1007/s00402-006-0284-5.CrossRefPubMed
9.
go back to reference Renger RJ, Roukema GR, Reurings JC, Raams PM, Font J, Verleisdonk EJ: The clavicle hook plate for Neer type II lateral clavicle fractures. J Orthop Trauma. 2009, 23: 570-574. 10.1097/BOT.0b013e318193d878.CrossRefPubMed Renger RJ, Roukema GR, Reurings JC, Raams PM, Font J, Verleisdonk EJ: The clavicle hook plate for Neer type II lateral clavicle fractures. J Orthop Trauma. 2009, 23: 570-574. 10.1097/BOT.0b013e318193d878.CrossRefPubMed
10.
go back to reference Lee KW, Lee SK, Kim KJ, Kim YI, Kwon WC, Choy WS: Arthroscopic-assisted Locking Compression Plate clavicular hook fixation for unstable fractures of the lateral end of the clavicle: a prospective study. Int Orthop. 2009 Lee KW, Lee SK, Kim KJ, Kim YI, Kwon WC, Choy WS: Arthroscopic-assisted Locking Compression Plate clavicular hook fixation for unstable fractures of the lateral end of the clavicle: a prospective study. Int Orthop. 2009
11.
go back to reference Kaipel M, Majewski M, Regazzoni P: Double-Plate Fixation in Lateral Clavicle Fractures-A New Strategy. J Trauma. 2010 Kaipel M, Majewski M, Regazzoni P: Double-Plate Fixation in Lateral Clavicle Fractures-A New Strategy. J Trauma. 2010
12.
go back to reference Robinson CM: Fractures of the clavicle in the adult. Epidemiology and classification. J Bone Joint Surg Br. 1998, 80: 476-484. 10.1302/0301-620X.80B3.8079.CrossRefPubMed Robinson CM: Fractures of the clavicle in the adult. Epidemiology and classification. J Bone Joint Surg Br. 1998, 80: 476-484. 10.1302/0301-620X.80B3.8079.CrossRefPubMed
13.
go back to reference Neer CS: Fractures of the distal third of the clavicle. Clin Orthop Relat Res. 1968, 58: 43-50.PubMed Neer CS: Fractures of the distal third of the clavicle. Clin Orthop Relat Res. 1968, 58: 43-50.PubMed
14.
go back to reference Neer CS: Fracture of the distal clavicle with detachment of the coracoclavicular ligaments in adults. J Trauma. 1963, 3: 99-110. 10.1097/00005373-196303000-00001.CrossRefPubMed Neer CS: Fracture of the distal clavicle with detachment of the coracoclavicular ligaments in adults. J Trauma. 1963, 3: 99-110. 10.1097/00005373-196303000-00001.CrossRefPubMed
15.
go back to reference Rokito AS, Zuckerman JD, Shaari JM, Eisenberg DP, Cuomo F, Gallagher MA: A comparison of nonoperative and operative treatment of type II distal clavicle fractures. Bull Hosp Jt Dis. 2002, 61: 32-39.PubMed Rokito AS, Zuckerman JD, Shaari JM, Eisenberg DP, Cuomo F, Gallagher MA: A comparison of nonoperative and operative treatment of type II distal clavicle fractures. Bull Hosp Jt Dis. 2002, 61: 32-39.PubMed
16.
go back to reference Robinson CM, Cairns DA: Primary nonoperative treatment of displaced lateral fractures of the clavicle. J Bone Joint Surg Am. 2004, 86-A: 778-782.PubMed Robinson CM, Cairns DA: Primary nonoperative treatment of displaced lateral fractures of the clavicle. J Bone Joint Surg Am. 2004, 86-A: 778-782.PubMed
17.
go back to reference Kona J, Bosse MJ, Staeheli JW, Rosseau RL: Type II distal clavicle fractures: a retrospective review of surgical treatment. J Orthop Trauma. 1990, 4: 115-120. 10.1097/00005131-199004020-00002.CrossRefPubMed Kona J, Bosse MJ, Staeheli JW, Rosseau RL: Type II distal clavicle fractures: a retrospective review of surgical treatment. J Orthop Trauma. 1990, 4: 115-120. 10.1097/00005131-199004020-00002.CrossRefPubMed
18.
go back to reference Ballmer FT, Gerber C: Coracoclavicular screw fixation for unstable fractures of the distal clavicle. A report of five cases. J Bone Joint Surg Br. 1991, 73: 291-294.PubMed Ballmer FT, Gerber C: Coracoclavicular screw fixation for unstable fractures of the distal clavicle. A report of five cases. J Bone Joint Surg Br. 1991, 73: 291-294.PubMed
19.
go back to reference Yamaguchi H, Arakawa H, Kobayashi M: Results of the Bosworth method for unstable fractures of the distal clavicle. Int Orthop. 1998, 22: 366-368. 10.1007/s002640050279.PubMedCentralCrossRefPubMed Yamaguchi H, Arakawa H, Kobayashi M: Results of the Bosworth method for unstable fractures of the distal clavicle. Int Orthop. 1998, 22: 366-368. 10.1007/s002640050279.PubMedCentralCrossRefPubMed
20.
go back to reference Goldberg JA, Bruce WJ, Sonnabend DH, Walsh WR: Type 2 fractures of the distal clavicle: a new surgical technique. J Shoulder Elbow Surg. 1997, 6: 380-382. 10.1016/S1058-2746(97)90006-9.CrossRefPubMed Goldberg JA, Bruce WJ, Sonnabend DH, Walsh WR: Type 2 fractures of the distal clavicle: a new surgical technique. J Shoulder Elbow Surg. 1997, 6: 380-382. 10.1016/S1058-2746(97)90006-9.CrossRefPubMed
21.
go back to reference Mall JW, Jacobi CA, Philipp AW, Peter FJ: Surgical treatment of fractures of the distal clavicle with polydioxanone suture tension band wiring: an alternative osteosynthesis. J Orthop Sci. 2002, 7: 535-537. 10.1007/s007760200095.CrossRefPubMed Mall JW, Jacobi CA, Philipp AW, Peter FJ: Surgical treatment of fractures of the distal clavicle with polydioxanone suture tension band wiring: an alternative osteosynthesis. J Orthop Sci. 2002, 7: 535-537. 10.1007/s007760200095.CrossRefPubMed
22.
go back to reference Jackson WF, Bayne G, Gregg-Smith SJ: Fractures of the lateral third of the clavicle: an anatomic approach to treatment. J Trauma. 2006, 61: 222-225. 10.1097/01.ta.0000196804.23024.a3.CrossRefPubMed Jackson WF, Bayne G, Gregg-Smith SJ: Fractures of the lateral third of the clavicle: an anatomic approach to treatment. J Trauma. 2006, 61: 222-225. 10.1097/01.ta.0000196804.23024.a3.CrossRefPubMed
23.
go back to reference Moneim MS, Balduini FC: Coracoid fracture as a complication of surgical treatment by coracoclavicular tape fixation. A case report. Clin Orthop Relat Res. 1982, 133-135. Moneim MS, Balduini FC: Coracoid fracture as a complication of surgical treatment by coracoclavicular tape fixation. A case report. Clin Orthop Relat Res. 1982, 133-135.
24.
go back to reference Eberle C, Fodor P, Metzger U: [Hook plate (so-called Balser plate) or tension banding with the Bosworth screw in complete acromioclavicular dislocation and clavicular fracture]. Z Unfallchir Versicherungsmed. 1992, 85: 134-139.PubMed Eberle C, Fodor P, Metzger U: [Hook plate (so-called Balser plate) or tension banding with the Bosworth screw in complete acromioclavicular dislocation and clavicular fracture]. Z Unfallchir Versicherungsmed. 1992, 85: 134-139.PubMed
25.
go back to reference Kiefer H, Claes L, Burri C, Holzwarth J: The stabilizing effect of various implants on the torn acromioclavicular joint. A biomechanical study. Arch Orthop Trauma Surg. 1986, 106: 42-46. 10.1007/BF00435651.CrossRefPubMed Kiefer H, Claes L, Burri C, Holzwarth J: The stabilizing effect of various implants on the torn acromioclavicular joint. A biomechanical study. Arch Orthop Trauma Surg. 1986, 106: 42-46. 10.1007/BF00435651.CrossRefPubMed
26.
go back to reference ElMaraghy AW, Devereaux MW, Ravichandiran K, Agur AM: Subacromial morphometric assessment of the clavicle hook plate. Injury. 2010, 41: 613-619. 10.1016/j.injury.2009.12.012.CrossRefPubMed ElMaraghy AW, Devereaux MW, Ravichandiran K, Agur AM: Subacromial morphometric assessment of the clavicle hook plate. Injury. 2010, 41: 613-619. 10.1016/j.injury.2009.12.012.CrossRefPubMed
27.
go back to reference Nadarajah R, Mahaluxmivala J, Amin A, Goodier DW: Clavicular hook-plate: complications of retaining the implant. Injury. 2005, 36: 681-683. 10.1016/j.injury.2004.08.010.CrossRefPubMed Nadarajah R, Mahaluxmivala J, Amin A, Goodier DW: Clavicular hook-plate: complications of retaining the implant. Injury. 2005, 36: 681-683. 10.1016/j.injury.2004.08.010.CrossRefPubMed
28.
go back to reference Chandrasenan J, Badhe S, Cresswell T, Beer J: The Clavicular Hook Plate: Consequences in Three Cases. European Journal of Trauma and Emergency Surgery. 2007, 5: 557-559.CrossRef Chandrasenan J, Badhe S, Cresswell T, Beer J: The Clavicular Hook Plate: Consequences in Three Cases. European Journal of Trauma and Emergency Surgery. 2007, 5: 557-559.CrossRef
29.
go back to reference Charity RM, Haidar SG, Ghosh S, Tillu AB: Fixation failure of the clavicular hook plate: a report of three cases. J Orthop Surg (Hong Kong). 2006, 14: 333-335. Charity RM, Haidar SG, Ghosh S, Tillu AB: Fixation failure of the clavicular hook plate: a report of three cases. J Orthop Surg (Hong Kong). 2006, 14: 333-335.
30.
go back to reference Nordqvist A, Petersson C, Redlund-Johnell I: The natural course of lateral clavicle fracture. 15 (11-21) year follow-up of 110 cases. Acta Orthop Scand. 1993, 64: 87-91.CrossRefPubMed Nordqvist A, Petersson C, Redlund-Johnell I: The natural course of lateral clavicle fracture. 15 (11-21) year follow-up of 110 cases. Acta Orthop Scand. 1993, 64: 87-91.CrossRefPubMed
Metadata
Title
Hook plate fixation of acute displaced lateral clavicle fractures: mid-term results and a brief literature overview
Authors
Davut Tiren
Alexander JM van Bemmel
Dingeman J Swank
Frits M van der Linden
Publication date
01-12-2012
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2012
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/1749-799X-7-2

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