Journal List > J Korean Fract Soc > v.24(4) > 1037836

Sohn and Jo: Results of Hook Plate Fixation of Unstable Distal Clavicle Fractures



This study evaluated the clinical and radiological outcomes of unstable distal clavicular fractures treated with an AO Hook plate.

Materials and Methods

From March 2009 to October 2010, sixteen patients with distal clavicular fractures underwent open plating using an AO Hook plate. The clinical outcomes were assessed by measuring the UCLA scores and KSS sores, and the radiological outcomes were evaluated using simple radiographs at the final follow-up.


Fracture union was obtained in all patients at an average of 13.9 weeks (range, 9~20 weeks). The UCLA scoring system showed excellent results in 9 cases and good results in 7. The average KSS scores of distal clavicular fractures were 95.5. At the final follow-up, subacromial osteolysis developed in 11 cases (68.7%) of whom 3 suffered from pain around the acromion. Other complications occurred in 4 patients: one had a fracture adjacent to the plate proximally, two had a stiff shoulder with subacromial impingement, and one had hypoesthesia around the surgical wound.


Unstable distal clavicular fractures treated with a Hook plate provided rigid fixation and satisfactory outcomes considering the high union rate. Nevertheless, potential postoperative complications related to morphometric properties of the plate should be considered.

Figures and Tables

Fig. 1
(A) 73-year-old male with a type IIb fracture of the distal clavicle.
(B) The distal clavicular fracture was stabilized with the Hook plate.
(C) Postoperative radiographs at 4 months showed union of the fracture.
Fig. 2
(A) Neer type IIa fracture of clavicle in a 39-year-old man.
(B) Shoulder radiograph obtained immediately postoperatively showed the normal cortical surface of acromion.
(C) At 13 months postopertively, a radiograph showed subacromial radiolucent lesion around the hook tip.
Fig. 3
(A) Clavicular fracture at the medial aspect of the hook plate.
(B) At 18 weeks postoperatively, a radiograph showed union of clavicular midshaft fracture.
Table 1
Details of the 16 cases


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