Hook-plate fixation of unstable lateral clavicle fractures: a report on 63 patients

Tapio Flinkkilä, Jukka Ristiniemi, Martti Lakovaara, Pekka Hyvönen, Juhana Leppilahti
Acta Orthopaedica 2006, 77 (4): 644-9

BACKGROUND: Hook-plate fixation of unstable lateral clavicle fractures has given promising results in previous reports, but numbers of patients have been small. We assessed the results of this technique in 63 patients.

PATIENTS AND METHODS: 63 patients with unstable lateral clavicle fractures were operated on at Oulu University Hospital during 1997-2004, using a clavicle hook-plate. Fracture union and complications were assessed retrospectively from case records and radiographs. The subjective part of the Constant score, Oxford shoulder questionnaire data and subjective shoulder value (SSV) were assessed after an average of 3.6 years in 58 patients. 31 patients were reviewed at the outpatient clinic, using complete Constant scores and radiographs of both acromioclavicular joints.

RESULTS: 59 fractures united uneventfully. There was 1 case of delayed union and 3 nonunions, but only 1 of these required surgery. Additional complications involved 1 case of infection, 1 frozen shoulder and 3 cases of late fracture medial to the plate. The mean Oxford score was 15, the mean for the subjective part of the Constant score was 32, and the SSV was 86%.

INTERPRETATION: Clavicle hook-plate fixation of unstable lateral clavicle fractures results in a good union rate and good shoulder function.

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