Medium Term Results Following Hook Plate Fixation of Lateral End of Clavicle Fractures

Lateral end clavicle fractures are uncommon but often lead to delayed union or non-union. This is particularly the case with displaced fractures treated non-operatively. We report our medium term results of patients with lateral end of clavicle fracture treated with operatively with hook plate fixation.

20 consecutive cases of lateral end of clavicle fractures were retrospectively reviewed to assess the union rate and functional outcome at a mean of 6.5 years post-operatively.

There were (14 male and 6 female) patients with a mean age of 39 years. 17 (85%) patients had acute fractures and 3 (15%) had established non-unions at the time of surgery.

Our management consisted of hook plate fixation in all 20 patients with ancillary bone grafting in three patients with non-union. Osseous union was achieved in all 20 patients with surgical stabilization at mean of 9.5 weeks. All patients had the plate removed at average 6.5 months. 23% of patients had persistent impingement symptoms and pain post-operatively, with 9% of the patients undergoing Subacromial decompression at a later date with resolution of the symptoms subsequently. The average DASH score at the time of the final follow up was 9.8 (0-28) and Oxford score was 17 (12-27). At the time of final follow up. 86% of patients had excellent to good results at final follow up.

Hook plate fixation for lateral end of clavicle fracture is a safe and reliable option to achieve union in this difficult group of patients with good results over medium term with a proportion of patients experiencing impingement symptoms.