The Radiologic Comparison of Operative Treatment Using a Hook Plate versus a Distal Clavicle Locking Plate of Distal Clavicle Fracture

Yoon, Byungil; Kim, Jae Yoon; Lee, Jae Sung; Jung, Hyoung Seok

Abstract

BACKGROUND
The purpose of this study was to compare the radiologic results of patients who underwent surgery with a hook plate and a locking plate in distal clavicle fractures.
METHODS
Sixty patients underwent surgical treatment for Neer type IIa, IIb, III, and V distal clavicle fracture. Twenty-eight patients underwent fracture fixation with a hook plate and 32 with a locking plate. Coracoclavicular distance was measured on standard anteroposterior radiographs before and after the surgery, and union was confirmed by radiograph or computed tomography taken at 6 months postoperatively. Other radiologic complications like osteolysis was also checked.
RESULTS
Bony union was confirmed in 59 patients out of 60 patients, and 1 patient in the hook plate group showed delayed union. Coracoclavicular distance was decreased more in the hook plate group after surgery (p < 0.01). After 6 weeks of the hook plate removal, the coracoclavicular distance was increased a little compared to before metal removal, but there was no difference compared to the contralateral shoulder. Eleven out of 28 patients (39.3%) showed osteolysis on the acromial undersurface in the hook plate group.
CONCLUSIONS
Both the hook plate group and the locking plate group showed satisfactory radiologic results in distal clavicle fractures. Both hook plate and locking plate could be a good treatment option if it is used in proper indication in distal clavicle fracture with acromioclavicular subluxation or dislocation.