title: The clavicle hook plate for Neer type II lateral clavicle fractures.
abstract: OBJECTIVE
  To evaluate functional and radiologic outcome in patients with a Neer type II lateral clavicle fracture treated with the clavicle hook plate.
  
  
  METHODS
  Multicenter retrospective study.
  
  
  METHODS
  Five level I and II trauma centers.
  
  
  METHODS
  Forty-four patients, average age 38.4 years (18-66 years), with a Neer type II lateral clavicle fracture treated with the clavicle hook plate between January 1, 2003, and December 31, 2006.
  
  
  METHODS
  Open reduction and internal fixation with the clavicle hook plate. Removal of all 44 implants after consolidation at a mean of 8.4 months (2-33 months) postoperatively.
  
  
  METHODS
  At an average follow-up of 27.4 months (13-48 months), functional outcome was assessed with the Constant-Murley scoring system. Radiographs were taken to evaluate consolidation and to determine the distance between the coracoid process and the clavicle.
  
  
  RESULTS
  The average Constant score was 92.4 (74-100). The average distance between the coracoid process and the clavicle was 9.8 mm (7.3-14.8 mm) compared with 9.4 mm (6.9-14.3 mm) on the contralateral nonoperative side. We observed 1 dislocation of an implant (2.2%), 2 cases of pseudarthrosis (4.5%), 2 superficial wound infections (4.5%), 2 patients with hypertrophic scar tissue (4.5%), and 3 times an acromial osteolysis (6.8%). Thirty patients (68%) reported discomfort due to the implant. These implant-related complaints and the acromial osteolysis disappeared after removal of the hook plate. With all the patients, direct functional aftercare was possible.
  
  
  CONCLUSIONS
  The clavicle hook plate is a suitable implant for Neer type II clavicle fractures. The advantage of this osteosynthesis is the possibility of immediate functional aftercare. We observed a high percentage of discomfort due to the implant; therefore, we advise to remove the implant as soon as consolidation has taken place.
authors.affiliation: Department of Surgery, Hospital de la Santa Creu i Sant Pau, Carrer St. Antoni Maria Claret, 167, 08025 Barcelona, Spain. rjrenger@hotmail.com
authors.forename: R J
authors.initials: RJ
authors.lastname: Renger
authors.forename: G R
authors.initials: GR
authors.lastname: Roukema
authors.forename: J C
authors.initials: JC
authors.lastname: Reurings
authors.forename: P M
authors.initials: PM
authors.lastname: Raams
authors.forename: J
authors.initials: J
authors.lastname: Font
authors.forename: E J M M
authors.initials: EJ
authors.lastname: Verleisdonk
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001860:Bone Plates; D002968:Clavicle / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D050723:Fractures, Bone / Q000145:classification* / Q000601:surgery*; D006801:Humans; D016268:Internal Fixators; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011474:Prosthesis Design; D011859:Radiography; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult