Lateral End Clavicle Fractures Research Articles

Implantless osteosynthesis of lateral end of clavicle fractures using autologous palmaris longus tendon graft for coracoclavicular ligament reconstruction

Background: Lateral end clavicle fractures require operative management because of significant displacing forces of trapezius, sternocleidomastoid and weight of the arm. Coracoclavicular ligaments are usually torn hampering vertical stability. Currently used implants for osteosynthesis are associated with implant impingement on acromion, poor purchase of lateral fragment and implant cut-out. There is a lack of consensus regarding ideal treatment of these fractures. Methods: 31 patients with lateral clavicle fracture who were admitted from May 2019 to August 2022 were enrolled in this study and underwent coracoclavicular ligament reconstruction using ipsilateral palmaris longus graft looped around coracoid and tied over clavicle to hold it reduced. Patients were assessed for pain, shoulder range of motion and functional outcome with 6-month follow-up. Results: All patients showed radiological union with good to excellent outcome in 79.3% patients and mean abduction of 157⁰. Mean duration of surgery was 104 minutes (SD±12.118) and 10.3% patients showed shoulder stiffness. Conclusions: The study shows encouraging prospect in purely biological osteosynthesis with functional outcome at par with other methods of fixation while avoiding implant related complications.

CLINICAL AND RADIOLOGICAL OUTCOME IN LATERAL END CLAVICLE FRACTURES FOLLOWING CLAVICLE LOCKING PLATE FIXATION

Aim: The lateral end clavicle fractures comprise around 25% of all clavicle fractures. Various deforming forces acting over here render this fracture unstable. There are various treatment options of the lateral end of clavicle ranging from non-operative to operative methods like coracoclavicular screws, k wire fixation, tension band wiring, hook plates, non- locking and locking plates and coracoclavicular augmentation. In this study, we have evaluated the functional and radiological outcomes of the patients in whom a locking plate was used for fixation of the lateral end of clavicle fractures. Methods: 15 patients with lateral end clavicle fractures underwent open reduction and internal fixation using a 3.5 mm pre-contoured superior locking plate under general anaesthesia or regional block. Regular post operative X-rays were done until radiological union was achieved. The postoperative pain was assessed using Visual Analogue Scale (VAS)on postoperative day 1 and at 2 weeks. The operated limb was supported by a sling for 3 weeks with intermittent passive and active assisted range of motion exercises. The functional outcome was assessed at the end of 1 month,3 months and 6 months postoperatively with the help of QuickDASH scoring system. Results: All the fractures achieved radiological union at an average duration of 12.1 weeks (range 9.8-13.4). The mean VAS score on post-operative day 1 was found to be 5 which decreased to 1 at two weeks postoperatively. The mean postoperative QuickDASH score was 52.23+/- 1.9 at the end of 1 month,20.4+/- 1.9 at 3 months and then 1.3 +/-1.6 at the end of 6 months. There was one case of implant backout with hardware promince and one case had superficial infection which responded to short course of oral antibiotics and dressings. Conclusion: The precontoured superior clavicle locking plates may be a good method to fix the fractures of the lateral end clavicle, providing a stable fixation with good radiological and functional outcome, although larger comparative studies between the various surgical treatment methods need to be done to validate this method of treatment.

CLINICO-FUNCTIONAL AND RADIOLOGICAL OUTCOME OF LATERAL END OF CLAVICLE FRACTURE MANAGED WITH SUBACROMIAL CLAVICULAR HOOK PLATE – AN PROSPECTIVE CASE STUDY

Introduction :- The use of the acromioclavicular hook plate to treat lateral-third clavicle fractures is controversial . This is believed to be a result of issues with the hook plate such as impingement symptoms, which can result in chronic pain and movement limitations. Our goal was to assess the radiological functional outcome of individuals with lateral end clavicle fractures managed with subacromial hook plate. Methods And Methodology :- We prospectively reviewed all 16 patients who underwent surgery from July 2020 to August 2022 using our electronic patient information database. All patients were assessed in the out patient department to determine both Oxford and Constant shoulder scores to assess the clico-functional outcomes. Among 16 patients who underwent surgery with the hook plate Results:- , 10 male and 6 female. The mean age was 36.2 years. The median length of hospital stay was 4 days. The median follow-up was 12 months. The median time from date of injury to surgery was 7 days one patient presented 4 months after injury. The mean time for fracture union was 3 months from the date of surgery and the union rate was 95%. In total, 13 of plates were removed. The median time for implant removal was 4.5 months. In a case of fracture lateral end of Conclusion: Clavicle, open reduction and internal xation with clavicular hook plate achieves reliable internal xation with early mobilization. In view of this we state that clavicular hook plate is an reliable option for treating these types of fractures.

Adolescent displaced lateral-end clavicle fractures are not comparable to the adult variant. Epidemiology, fracture patterns and outcome of non-operative management.

The primary aim of this study was to determine the epidemiology of lateral-end clavicle fractures in adolescents. The secondary aim was to assess the outcome following non-operative management. A retrospective review of all adolescent clavicle fractures over a 10-year period was undertaken. Fracture classification, demographics, management, and complications were analysed. Functional outcomes were undertaken with the Quick Disabilities of Arm, Shoulder and Hand and EuroQol five-dimension at mean 8.8 years post-injury. In total, 677 clavicle fractures were analysed, 8.7% were lateral-end fractures (n = 59/677). The median age was 14.6 (range: 13-17) and 92% were male (n = 54/59). The incidence was 0.17 per 100,000 per year. All displaced physeal fractures (Neer IV n = 14) were managed non-operatively and of the six followed-up, all united with good outcomes. The adult type displaced fracture (Neer II) occurred in fifteen fractures, five underwent operative fixation and ten were managed non-operatively with one subsequent nonunion (n = 1/10). Those patients that underwent non-operative management (response n = 5/10, 50%) reported a median Quick Disabilities of Arm, Shoulder and Hand of 2.3 but approximately 40% reported cosmetic and outcome dissatisfaction at long-term follow-up. Displaced Neer II lateral-end clavicle fractures are rare in the adolescent population. Although nonunion is rare, some dissatisfaction with cosmesis persists at long-term follow-up despite good functional outcomes with non-operative management.

Mid-term outcome of arthroscopic TightRope fixation of displaced lateral end clavicular fractures: Average follow-up of 6.1 years

PurposeVarious surgical modalities are available to treat Neer types 2 and 5 unstable fractures of lateral end clavicle but none of them are standardized. Arthroscopic fixation of the displaced lateral end clavicle fractures provides good short-term results but mid- to long-term outcomes are not available. The purpose of this study was to show the mid- to long-term radiological and functional outcomes of these fractures treated arthroscopically by a TightRope device, and to show the complications associated with this procedure. MethodsA retrospective study was conducted over 2 years from January 2014 to December 2015 with a minimum 5-year follow-up. Active patients aged 18–50 years with acute (less than 3 weeks) displaced fracture of lateral end of the clavicle, with a minimum 5-year follow-up were included in the study. Patients with associated fractures of the proximal humerus, glenoid, scapula and acromioclavicular joint injuries were excluded from the study along with open fractures and neurovascular injuries. The outcomes were assessed by objective (complications and radiographic examination) and subjective criteria (quick disabilities of the arm, shoulder and hand score, the Constant-Murley score and the visual pain analogue scale). The data were analyzed by SPSS version 21.0. ResultsTotally, 42 patients were operated during the study period and 37 were available with a minimum 5-year follow-up. Thirty were male and 7 were female with a mean age of 29.5 years and a mean follow-up of 6.1 years. The mean quick disabilities of the arm, shoulder and hand score was 68.2 ± 4.6 preoperatively and 1.27 ± 2.32 at final follow-up (p < 0.001); the mean visual pain analogue scale score was 6.85 ± 2.2 preoperatively and 0.86 ± 1.60 at final follow-up (p < 0.001). The average Constant-Murley score was 93.38 ± 3.25 at the end of the follow-up. There were 2 fixation failures, with established non-union and 3 patients developed radiographic acromioclavicular joint arthritis. ConclusionsArthroscopic TightRope fixation of displaced lateral end clavicular fractures provides good radiological and functional outcomes at mid- to long-term follow-up. With the low complication rates and high patient satisfaction, this technique can be considered as a primary option in the surgical treatment of these fractures.

Comparative Analysis of Clavicular Hook Plate Versus Distal Radius Volar Plate With Coracoclavicular Augmentation for Neer's Type 2b Lateral Clavicle Fractures: A Prospective Study.

BackgroundClavicle fractures are common injuries in the adult population. The commonest site of fracture in the clavicle is the mid-shaft followed by the lateral end fracture. The anatomy and biomechanics of the lateral end clavicle make it prone to be unstable. Conservative management usually fails due to the deforming forces.AimOur study evaluates pain relief, functional outcome, and the union rate in unstable lateral end clavicle fracture fixed by two different modalities of operative management, namely clavicular hook plate fixation and distal radius volar plate fixation.Materials and methodA total of 60 patients with the unstable lateral end of clavicle fracture were evaluated in this study at a single tertiary care center between August 2015 and September 2021. Half of the patients (30 patients) were managed by open reduction and internal fixation with clavicular hook plate. The remaining half (30 patients) underwent open reduction and internal fixation by distal radius volar plate supplemented with coracoclavicular fixation. All patients were followed up for a mean duration of 20 months. The functional outcome was assessed at regular intervals by Constant score and Disability of the Arm, Shoulder and the Hand (DASH) score for a period of one year.ResultThere was significant pain relief and improvement in the functional status of patients. The pain relief was significant in the group managed by distal radius volar plate. The decrease in DASH score and increase in Constant score suggests better functional outcomes in these patients.ConclusionOur study highlights the fact that the distal radius volar plate is an excellent alternative to the hook plate in the treatment of unstable lateral third clavicle fractures. The decrease in pain and improved functional outcome stresses the fact that the volar locking plate is the recent most advancement in the fracture fixation of Neer’s type ll fractures. The distal radius volar plate is the recent internal fixation technique to manage unstable lateral end clavicle fractures.

Management of lateral end clavicle fractures using hook plate -A prospective study

Background: The study was conducted to assess the functional outcome of hook plate for displaced lateral end clavicle fractures using Constant Murley score. Materials and Methods: This study include total of 15 cases with displaced lateral end clavicle fractures satisfying the inclusion criteria treated with hook plate. Patients were followed up at 1st month, 2nd month and 6th month, the functional outcome was assessed using Constant Murley score and the radiological outcome was also assessedResults: In our study, 15 cases treated with hook plate 26.7% of patients had excellent outcome and 73.3% had good outcome and postoperative shoulder impingement seen in 13% of patientsConclusion: Hook plate has a good functional outcome for lateral end clavicle fractures. Hook plate is an absolute indication for commenuted lateral end clavicle fractures. Hook plate has implant-related complications, hence implant removal should be advised.

Management of lateral end clavicle fractures using lateral clavicle locking plate: A prospective study

Background: The study was conducted to assess the functional outcome of clavicular lateral clavicle locking plate for displaced lateral end clavicle fractures using Constant Murley score. Materials and Methods: This study include total of 15 cases with displaced lateral end clavicle fractures satisfying the inclusion criteria treated with lateral clavicle locking plate. Patients were followed up at 1st month, 2nd month and 6th month, the functional outcome was assessed using Constant Murley score and the radiological outcome was also assessed.Results: In our study, 15 cases treated with lateral clavicle locking plate 6.7% of patients had excellent outcome and 66.7% had good outcome with plate backout and dislocation seen in6.7% of patients.Conclusion: locking plate have a good functional outcome for lateral end clavicle fractures. Addressing the coracoclavicular ligaments in case of lateral locking plate is of utmost importance in comminuted lateral end clavicle fractures.

Prospective study of clinico radiological outcome of distal end clavicle fractures treated with hook plate

Background & Objectives: Clavicle fracture is the commonest fracture amongst adults and roughly a quarter of all clavicle fractures occur at the lateral end [1]. These fractures are unstable due to the various deforming forces which act on the fragments as well as the small distal fracture fragment. At most times the deforming forces are not taken into consideration, and the fracture is not fixed securely. In this study, we assessed a fixation technique using the lateral end clavicle hook plates to find out whether it provided a stable fixation with good functional outcome. Methods: This study is a prospective, hospital based study conducted in Anil Neerukonda Hospital and NRI Institute of Medical Sciences, Visakhpatnam, between May 2018 to May 2021. The fractures were classified according to Neer’s classification and were followed up at regular intervals.In total, 12 patients with lateral end clavicle fracture (Neer's Type II) were included in the study. After the informed consent and preoperative investigations were obtained, open reduction and internal fixation was done using a 3.5 mm lateral end clavicular hook plate under regional anesthesia. Postoperative X-rays were done on day 1 and every 6 weeks after operation, until radiological union was achieved. The postoperative pain was assessed using Visual Analogue Scale (VAS) on postoperative days 1, 2 and 10. Postoperatively arm pouch sling was given for 10 days followed by active mobilization. Patients were asked to do their daily routine work and avoid lifting heavy weights. The functional outcome was assessed at the end of 2nd and 6th months with the help of Disabilities of the Arm, Shoulder and Hand (DASH) scoring. Results: There were no intraoperative complications in the procedure. The mean VAS score on postoperative day 1 was found to be 5 which decreased to 3 on day 2 and 0 on day 10. The mean DASH score was calculated as 10.58 at the end of postoperative month 2 and then 4.2 at the end of month 6. There was one case of superficial infection which was resolved with local debridement, there was initial restriction of overhead abduction in this case but was not painful and was managed conservatively. Conclusion: Lateral end clavicular hook plate is a good fixation system for lateral end clavicle fractures. Operative time is reduced and surgical dissection is minimum. Device provides good angular stability and helps in early mobilization. It may well be the answer to the fixation questions of the lateral clavicle fractures, although larger comparative studies between the surgical treatment methods are required to confirm the same.

Functional outcomes and complications following combined locking plate and tunneled suspensory device fixation of lateral-end clavicle nonunions.

Lateral-end clavicle fractures have a high rate of nonunion that can lead to ongoing pain and loss of shoulder function. The operative techniques used to manage such nonunions vary, and data on postoperative functional outcomes and complications are limited, with no consensus on the optimal surgical treatment. Our goal was to present the outcomes and complications of a new indication for combined locking plate and tunneled suspensory device fixation in the operative management of lateral-end clavicle fracture nonunions. A consecutive series of 38 patients (mean age, 46 years; age range, 24-76 years) with symptomatic lateral-end clavicle nonunions underwent operative treatment using a new technique of anatomic locking plate combined with open reduction and tunneled suspensory device fixation between March 2011 and September 2019. Patients were assessed at a minimum of 1-year postoperative follow-up for patient-reported outcomes, range of motion, and complications. All patients (N = 38) achieved bony union after operative treatment. Functional outcomes were available for 34 patients. The mean Oxford Shoulder Score was 44 (standard error of the mean [SEM], 0.7), and the mean EQ-5D-3L index score was 0.784 (SEM, 0.033). Mean forward flexion was 176° (SEM, 3°); mean extension, 53° (SEM, 3°); mean combined abduction, 171° (SEM, 4°); mean internal rotation, 57° (SEM, 2°); and mean external rotation, 83° (SEM, 4°). In 2 patients (5.3%), metalwork (plate) removal was performed owing to plate prominence. Nonunion of lateral-end clavicle fractures can be effectively managed by combined plate and open reduction-tunneled suspensory device fixation. Excellent union rates and functional outcomes, as well as low complication rates, can be expected. The most significant complication of this technique is subsequent metalwork removal.

Outcome following management of unstable lateral end clavicle fractures with locking plate and coracoid anchor augmentation.

Management of complex lateral end clavicle fractures with coraco-clavicular ligament disruption can be challenging. We prospectively analysed 19 (17 M:2F) patients from January 2014 to June 2016. Six patients had intra-articular fractures (Edinburgh-3B2) and the remaining were extra-articular (3B1). All patients had open reduction internal fixation with lateral end locking plate augmented with a coracoid anchor. All patients were evaluated at the final follow-up by American Shoulder and Elbow Surgeon score (ASES), Disabilities of the Arm, Shoulder and Hand (DASH), Oxford Shoulder Score (OSS), return to work, sports and radiographs. At a mean follow-up of 54 months (range 37-64), 19 patients were available for analysis. Mean age of patients was 34 years (range 24-65). At final follow-up DASH score was 1.66 (range 0-5); ASES score was 98.14 (93.3-100) and OSS was 46.6 (42-48). There was no difference in the functional outcome between 3B1 and 3B2 fractures (DASH - p(0.51); ASES - p(0.44); OSS - p(0.69)). All patients returned to preinjury level of function, sports and work. Five patients needed implant removal and three developed capsulitis that resolved with conservative treatment. Locking plate fixation, augmented with coracoid anchor is an effective option in the management of these complex injuries. The need for implant removal is reduced (26%) and there is no difference in the functional outcome between 3B1 and 3B2 fractures.

Clinical Outcome of Neer Type II Lateral End Clavicle Fractures With Coracoclavicular Ligament Disruption Treated With Pre-Contoured Locking Plate and Endobutton.

IntroductionMany surgical techniques have been described for the treatment of Neer type II lateral end clavicle fractures like open reduction and internal fixation with hook plate, tension band wiring, coracoclavicular screw fixation, and distal clavicle locking plate. However, most of these operative procedures are associated with high perioperative complications ranging from hardware prominence, hardware failure, screw and plate pull-out, and infection. As the lateral end clavicle fractures has both vertical and horizontal stress forces, any technique counteracting both the forces should result in a better clinical outcome. Therefore, this study was conducted to assess the functional and radiological outcome of type II lateral end clavicle fracture treated using pre-contoured locking plate along with coracoclavicular reconstruction with endobutton and fiberwire.MethodsThirty-two consecutive patients with Neer type II fractures of the lateral end of clavicle were treated surgically using pre-contoured locking plate and coracoclavicular reconstruction with endobutton and fiberwire between May 2014 and December 2016. Clinical outcome was assessed using the University of California Los Angeles (UCLA) shoulder score and Constant Murley score. The coracoclavicular distance was also recorded. These were compared to the unaffected side at one-year follow-up.ResultsThe bony union was achieved in all cases. There were no major complications in any of the patients. All the patients were able to return to their preinjury level of activity. The UCLA score, the Constant Murley score, and coracoclavicular distance did not vary significantly at a one-year interval when compared to the normal shoulder.ConclusionOpen reduction and internal fixation of Neer type II lateral end clavicle fractures using pre-contoured locking distal clavicle plate along with coracoclavicular reconstruction with endobutton and No. 2 fiberwire provide an excellent functional and radiological outcome.

Functional outcome of clavicle hook plate for fractures of lateral end of clavicle and acromio-clavicular joint disruption

Background: The acromioclavicular joint (AC joint) provides a ‘keystone’ link between the clavicle and the scapula. Objectives: To evaluate the functional outcome of clavicle hook plate for fractures of lateral end of clavicle & acromioclavicular joint disruption. Method: This study is a descriptive analysis, approved by the Institution Review Board and the Ethic Committee for the evaluation of the results of hook plate fixation for acromioclavicular joint disruption (Rockwood and Young III-VI) and unstable fractures of the lateral end of clavicle (Neer type II-III). Duration of study from 1st November 2018 to 31st May 2020. Results: 35 patients were followed of which 28 were males and 7 were females. Left shoulder was involved in 26 patients and right shoulder was involved in 9 patients. There were 25 patients with lateral end clavicle fractures and 10 patients with AC joint injury. Two patients had Diabetes mellitus and 5 patients had hypertension. One patient had both DM and hypertension. Two patients developed shoulder stiffness and two patients developed impingement during the course of follow up. All the patients had a unified surgical approach and operative procedure. The postoperative protocol regarding medication and physiotherapy was also unified (as mentioned earlier). At the last follow up, 27 patients had a excellent outcome according to Quick DASH score. 6 had a good outcome and 2 had a poor outcome. The score ranged from 2.3 to 25 (avg was 7.26) Conclusion: It was concluded Hook plate is a good option for treatment of AC joint disruption and unstable lateral end clavicle fractures, limited use of instrumentation, short duration of the procedure, stability to the AC joint attained without the need for ligament repair or reconstruction and short learning curve.

Management of unstable lateral end clavicle fracture with suture anchor technique - single centre experience

Fracture of the lateral end clavicle especially displaced fractures like the type II b are difficult to manage. Superior displacement due to deforming forces of trapezius and the small distal lateral fracture fragment cause difficulty in surgical management. Suture anchor technique is an easy and reliable way of fixing these fractures and has a superior functional outcome. This study illustrates the functional outcome following suture anchor fixation of lateral end clavicle fractures.Materials and Methods: 153 fracture clavicle since 2011 out of which 23 are lateral end clavicle fracture of which are stable and treated conservatively among these 11 patients had type 2 unstable distal end fracture and thus selected to undergo surgical intervention.Results: A total of 11 patients with type II clavicle fractures were enrolled in our study (9 males, 2 females). Mean patient age was 43.1±8.5 years, and mean follow-up period was 25.3 months (range: 12–56 months). CMS scores for all 11 patients at 3 and 12 months postoperatively were 73.10±5.43 and 91.63±3.72, respectively.Conclusion: Several methods of fixation with K wire, open reduction and internal fixation (ORIF) with plate and screws spanning the acromioclavicular joint, hook plate, coracoclavicular screw fixation and suture anchor fixation wires have been described in literature. For unstable lateral end clavicle fractures stabilization with suture anchor is a safe, reliable management and less technically demanding mode of management with good results.

The use of Tightrope device as the sole method of fixation in treating lateral end clavicle fractures.

Lateral end clavicle fractures can be challenging due to the small and often comminuted lateral fragment, problems with union and stability and implant morbidity. We retrospectively reviewed outcomes of Tightrope device in isolation to treat lateral end clavicle fractures. Subjective and objective measures were assessed for 29 patients. The subjective comprised of functional clinical scores: Oxford shoulder score and EuroQoL5D. The objective measures were maintenance of fracture reduction, bone healing and complications. Median age was 36 years and 72% of cases were male patients. Average clinical follow up time was 21 months. Evaluation of latest radiographs showed that all reductions were maintained post-operatively. Twenty-two fractures had united and one patient had established non-union. Functional outcomes showed predominantly good results with Oxford shoulder score average of 41, EuroQoL5D index score of 0.78 and EuroQol Visual Analogue Scale 76. The overall post-operative complication rate was 10%; only one case requiring a secondary procedure. In our series, using the Tightrope as the sole device to treat displaced lateral end of clavicle fractures resulted in good radiological and functional outcomes, with minimal complications requiring secondary procedures. We believe the Tightrope device is a good method of fixing these challenging fractures and advocate its use.

Treatment of fractures of lateral end of clavicle with open reduction using clavicle hook plate

Background: Fracture of lateral end clavicle constitutes merely 15% of clavicle fracture, only a third of these fractures are displaced. No solo treatment method has been hailed as the most favored technique to deal with the fracture lateral end clavicle, yielding consistently good union, with least complications. Objective: This early study attempts to assess the role of Clavicle Hook Plate, in the dealing lateral end clavicle fractures, whether it promises to be the most preferred technique.Material and Methods: To assess the results and long term effects in use of this plate we performed a retrospective analysis with a mean follow up of 24 months (2 years) of 20 patients with acute displaced lateral clavicle fractures, fixed with the clavicle hook plate. Results: Our short term results in all patients were first-class to excellent. None underwent non- union. Impingement symptoms were detected in 4 patients, 1 patient had skin/soft tissue issues and 1 had infection, warranting early implant removal. patients were re-evaluated at a mean follow-up period of 2 years. Conclusions: Clavicle hook plate is a reasonably good key treatment choice in fixing the acute displaced lateral end clavicle fractures. Proper selection of patients with good skin conditions and infection control are essential.

Functional outcome for the acromioclavicular joint disruption with or without lateral end clavicle fractures treated with hook plate

BACKGROUND: Acromioclavicular (AC) joint dislocation is most frequently encountered in contact sports and is far more common in males. Grade-III AC dislocation involves complete loss of contact between the clavicle and acromion secondary to the total disruption of both the AC and coracoclavicular ligaments, with loss of vertical and horizontal stability, respectively. The use of hook plate on open reduction and internal fixation of the AC joint dislocation had a little adverse effect on shoulder function and is an effective method for the treatment of AC joint dislocation. Hence, this retrospective study was carried out to assess the clinical and functional outcome of AC joint injuries treated with hook plate. AIM: The aim of this study is to assess and document the clinical and functional outcome of AC joint dislocation with or without lateral end clavicle fracture treated with hook plate. MATERIALS AND METHODS: This retrospective study of patients with Rockwood Type III AC joint disruption (dislocation) who were treated in our hospital. During the period from July 2013 to July 2018, a total of 33 patients with Type III AC joint disruption with or without associated lateral end clavicle fractures were included in this study, with 26 males and 7 females. The functional outcome was assessed using the CONSTANT scoring system during follow-up after hook plate fixation at 4 weeks, 3 months, 6 months, and 12 months. RESULTS: Thirty three patients with AC joint disruption were participated in the study after meeting the inclusion and exclusion criteria. There were 26 males (78.8%) and 7 females (21.2%) with a mean age of 44.7 years, eight patients had an associated lateral end clavicle fracture. All the patients were fixed with hook plate were followed up for a period of 1 year postoperatively. The mean Constant score improved progressively from a preoperative score of 44.5 to postoperative score of 68.3 at 4 weeks, 77.9 at 3 months, 89.4 at 6 months, and 93.3 at 12 months. CONCLUSIONS: In the current study, we conclude that the surgical and functional outcomes after AC joint stabilization with or without lateral end clavicle fractures using hook plate fixation yield satisfactory results. The hook plate also provides good horizontal, rotational, and vertical stability. Furthermore, the maintenance of reduction by the hook plate was significantly superior compared to the other modes of treatment. The hook plate also facilitates early mobilization and prevents stiffness of the shoulder joint.

Treatment of fractures of the lateral end clavicle by hook plate

Aim To assess the outcomes of management of an unstable fracture of the lateral end of the clavicle with clavicular hook plate. Patients and methods A total of 23 patients with displaced fracture lateral end clavicle were treated with clavicular hook plate fixation. The mean age of patients was 38.5 years (range, 28–55 years). Results The mean follow-up period was 20 months (range, 28–39 months). The mean fracture healing time was 12 weeks after operation. One (4.2%) patient had nonunion with good alignment without functional disability and was asymptomatic. One patient had a superficial wound infection. One patient had impingement, and his pain was resolved shortly after plate removal. AC joint arthrosis was reported in one patient. The mean constant score for the affected shoulder was 90 points (87–100), whereas the mean score for the contralateral shoulder was 96 points (92–100). The plate was removed in three (13%) patients only. Conclusion Clavicular hooked plate is a good method for management of lateral end clavicle fractures. It can provide stable fixation with a low rate of complications. Removal of the plate is not necessary.

Management of lateral end clavicle fractures-using lateral clavicle locking plate: a prospective study

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Lateral end clavicle fractures are one of the common upper limb fractures. They constitute 21–28% of all clavicle fractures. Of these 10–52% is displaced fractures. The management of fractures of lateral end clavicle remains debated and challenging. The objectivbe of this study is to evaluate the functional outcome following surgical treatment of unstable/displaced (Neer type II lateral clavicle fractures, and acromio-clavicular joint dislocations Rockwood grade III to V) lateral end clavicle fractures using lateral clavicle locking plate.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; It is a prospective study conducted in the orthopaedics department of GSL Medical College and General Hospital for a period of 3 years (April 2016 to March 2019) among a total of 60 patients.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; About 23 (38.3%) belonged to 41–50 years age group, followed by 16 (26.7%) to 31–40 years age group and 13 (21.7%) to &amp;gt;51 years age group and 8 (13.3%) to 18–30 years age group. The time from trauma to surgery ranged from 0-15 days with a mean of 5 days and the mean operating time was 41 minutes ranging between 23-70 minutes. Mean duration to union was 13.33±2.126 weeks and the mean Constant Murley score was 88.56. Functional outcome at 6 months follow up was excellent in 8 (13.3%), good in 37 (61.7%), fair in 13 (21.7%) and poor in 2 (3.3%) patients.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Although there is no consensus as to a “gold standard” fixation method for unstable distal clavicle fractures, satisfactory outcomes could be obtained using the lateral clavicle locking plate resulting in sufficient stabilization and good functional outcome.&lt;/p&gt;

Treatment of displaced lateral clavicular fractures with hook plate, a retrospective review

Fractures of the clavicle have been treated historically by conservative means. However lateral end fractures of clavicle are known to be unstable due to injury to the coracoclavicular ligaments. Hook plate has been used in open reduction and internal fixation of displaced lateral end clavicle fractures. This is a retrospective study of 28 cases of displaced lateral end clavicle fractures treated with ORIF with hook plate, in our hospital between Jan 2009 to Feb 2012. Constant –Murley shoulder function scoring system and DASH scoring was used to evaluate shoulder function. Average Constant Murley score was 86.5 at 4.5 years follow up. Average DASH score was 2.65. Three patients exhibited radiological signs of acromio-clavivular joint arthrosis, and one was symptomatic. All patients achieved bony union. One patient had infection which necessitated debridement, but fracture united