title: Hook plate fixation of acute displaced lateral clavicle fractures: mid-term results and a brief literature overview.
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.
authors.affiliation: Department of Surgery, Amphia Ziekenhuis, Breda, The Netherlands. D.Tiren@gmx.net
authors.forename: Davut
authors.initials: D
authors.lastname: Tiren
authors.forename: Alexander J M
authors.initials: AJ
authors.lastname: van Bemmel
authors.forename: Dingeman J
authors.initials: DJ
authors.lastname: Swank
authors.forename: Frits M
authors.initials: FM
authors.lastname: van der Linden
mesh_terms: D000293:Adolescent; D000328:Adult; D001860:Bone Plates; D002968:Clavicle / Q000293:injuries* / Q000601:surgery; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010014:Osteolysis / Q000209:etiology; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D019534:Shoulder Impingement Syndrome / Q000209:etiology; D013530:Surgical Wound Infection / Q000209:etiology; D016896:Treatment Outcome; D055815:Young Adult