Session VI - Upper Extremity

Clavicular Hook Plate for Lateral End Fractures

Prasad Meda, MD; Bhuvaneswar Machani, MD; Ian Braithwaite, MD; C. Sinopidis; P. Brownson; Simon P. Frostick, MD; Royal Liverpool University Hospital, Liverpool, United Kingdom

Purpose: We evaluated the clinical outcome of Neer's type II and III fractures of the lateral end of the clavicle with use of a new implant, the clavicular hook plate.

Methods: A prospective study was carried out over a period of 4 years; 31 patients (24 men and 7 women) with a mean age of 49.2 years ( range, 25 to 86) were treated with use of the clavicular hook plate. The mean follow-up was 28.34 months (range, 6 to 56). There were 21 type II and 10 type III fractures; 23 patients were operated on primarily and 8 patients were operated on for symptomatic nonunion.

Results: All the patients achieved clinical and radiologic union in a mean of 12.71 weeks (range, 10 to 16). The mean Constant score was 94 (range, 82 to 100) of a maximum 100. The Hospital for Special Surgery score for 9 patients was excellent, for 21 was good, and one patient had an average result. There were two superficial wound infections; 25 patients have had their implants removed to date.

Conclusions: The clinical results of use of the clavicular hook plate were good. The advantages are anatomical reduction of these fractures, easy surgical technique, and early rehabilitation leading to good shoulder girdle function.