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Use of the AO hook-plate for treatment of unstable fractures of the distal clavicle

  • Trauma Surgery
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We used a new internal fixative implant, the AO clavicle hook-plate, for treatment of unstable fractures of the distal clavicle. This study describes the operative procedure and the clinical results obtained, as well as discussion of the advantages and problems encountered.

Patients and methods

Fifteen consecutive patients with unstable fractures of the distal clavicle (Neer type II) were treated using AO clavicle hook-plates. The average age of patients was 47 years and there were 13 males and 2 females. The mean follow-up period was 15.5 months. Plain radiographs of clavicles were used to assess bony union. Functional recovery of the shoulder joint was assessed using the Constant–Murley scoring system.


All fractures eventually achieved solid bony union within 4 months after surgery. Thirteen patients (87%) showed hook migration into the acromion. Clinical results were excellent with a mean Constant–Murley score of 89 points at final follow-up.


AO clavicle hook-plates are useful fixative implants for unstable fractures of the distal clavicle. Static fixation was achieved and physiotherapy can be started immediately after surgery. Early removal of the implant is recommended however because hooks inserted under the acromion migrated into the bone in most cases.

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  1. Constant CR, Murley AH (1987) A clinical method of functional assessment of the shoulder. Clin Orthop 214:160–164

    PubMed  Google Scholar 

  2. Fann CY, Chiu FY, Chuang TY, Chen CM, Chen TH (2004) Transacromial Knowles pin in the treatment of Neer type 2 distal claviclefracturesA prospective evaluation of 32 cases. J Trauma 56:1102–1105

    PubMed  Google Scholar 

  3. Faraj AA, Ketzer B (2001) The use of a hook-plate in the management of acromioclavicular injuries. Report of ten cases. Acta Orthop Belg 67:448–451

    PubMed  CAS  Google Scholar 

  4. Flinkkila T, Ristiniemi J, Hyvonen P, Hamalainen M (2002) Surgical treatment of unstable fractures of the distal clavicle: a comparative study of Kirschner wire and clavicular hook plate fixation. Acta Orthop Scand 73:50–53

    Article  PubMed  Google Scholar 

  5. Goldberg JA, Bruce WJ, Sonnabend DH, Walsh WR (1997) Type 2 fractures of the distal clavicle: a new surgical technique. J Shoulder Elbow Surg 6:380–382

    Article  PubMed  CAS  Google Scholar 

  6. Kao FC, Chao EK, Chen CH, Yu SW, Chen CY, Yen CY (2001) Treatment of distal clavicle fracture using Kirschner wires and tension-band wires. J Trauma 51:522–525

    Article  PubMed  CAS  Google Scholar 

  7. Kona J, Bosse MJ, Staeheli JW, Rosseau RL (1990) Type II distal clavicle fractures: a retrospective review of surgical treatment. J Orthop Trauma 4:115–120

    Article  PubMed  CAS  Google Scholar 

  8. Levy O (2003) Simple, minimally invasive surgical technique for treatment of type 2 fractures of the distal clavicle. J Shoulder Elbow Surg 12:24–28

    Article  PubMed  Google Scholar 

  9. Mizue F, Shirai Y, Ito H (2000) Surgical treatment of comminuted fractures of the distal clavicle using Wolter clavicular plates. J Nippon Med Sch 67:32–34

    Article  PubMed  CAS  Google Scholar 

  10. Monsaert A, Steenbrugge R (2003) Repair of complete acromioclavicular separations: hook-plate verus K-wiring. Folia Traumatol Lovan 90:14–17

    Google Scholar 

  11. Neer CS II (1968) Fractures of the distal third of the clavicle. Clin Orthop 58:43–50

    PubMed  Google Scholar 

  12. Postacchini F, Gumina S, De Santis P, Albo F (2002) Epidemiology of clavicle fractures. J Shoulder Elbow Surg 11:452–456

    Article  PubMed  Google Scholar 

  13. Tan A, Nakano A, Horikoshi M (2002) Surgical treatment of distal clavicular fracture and acromioclavicular dislocation using Wolter clavicular plate and titanium acromioclavicular joint plate (in Japanese). Kossetsu 24:454–457

    Google Scholar 

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Correspondence to K. Muramatsu.

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Muramatsu, K., Shigetomi, M., Matsunaga, T. et al. Use of the AO hook-plate for treatment of unstable fractures of the distal clavicle. Arch Orthop Trauma Surg 127, 191–194 (2007).

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