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THE CLAVICLE HOOK PLATE IN THE TREATMENT OF FRACTURED DISTAL CLAVICLES AND AC DISLOCATIONS



Abstract

Acromioclavicular (AC) joint dislocations and fractures of the distal clavicle present challenging problems for the treating surgeon. We treated eight patients using a hook-shaped plate fixed to the distal clavicle and ‘hooked’ under the posterior acromion.

In five patients the injury was a fractured distal clavicle and in three an AC joint dislocation. We analysed the time taken to achieve a functional capacity. The eventual functional result was indexed from the time of fracture union or complete stabilisation of the dislocations.

All five fractures went on to anatomical union. The three dislocations were all stabilised with no instability or sub-luxation. Two patients complained of impingement symptoms and decreased overhead functional capacity. After the implant was removed, both patients regained a full range of pain-free movement.

This is a small study with limited follow-up. However, the results suggest that this new implant provides an acceptable alternative in the management of distal clavicle fractures and AC joint dislocations. The complication of impingement can be treated by removal of the implant after union or stabilisation has been achieved.

The abstracts were prepared by Professor M. B. E. Sweet. Correspondence should be addressed to him at The Department of Orthopaedic Surgery, Medical School, University of Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193 South Africa