Untitled

Abstract

Objectives:The objective of this study was to assess the outcome of displaced lateral third clavicle fractures which were fixed using hook plates. Introduction:The lateral third clavicle fractures in adults are unstable fractures requiring operative treatment and are prone to non-union and delayed union. The clavicle hook plate is one of the many operating techniques that can achieve a high rate of union and relatively low rate of complications for this type of fracture, as evident from its extensive use in the last decade or so. Literature suggests good results with many studies reporting union rates of up to 100%. However, the technique is not without its fair share of controversies regarding complications like shoulder impingement, resulting in long term shoulder pain and subacromial osteolysis. We aim to assess the outcome of the patients treated with hook plate and determine whether this technique has good outcome.Methods: 22 patients, who were previously operated on at two health-care centres of Peshawar from April 2016 to March 2019 for displaced fractures of the lateral third of the clavicle by using hook plate technique, were assessed retrospectively from case records and radiographs and clinical examinations of patients, to determine their functional and radiological outcome. The follow-up duration ranged from six months to three years. Result:The average age was 31.6 years with range of 18 to 53 years. Among these 17 were males and 5 females. All the fractures united successfully making the union rate 100%. The implant was removed from 6 of the cases, with only 3 of them due to complications. One of them had a periprosthetic fracture while the other 2 experienced persistent pain and limitation of abduction. Only 37% of the patients had long-lasting pain and 16% complained of stiffness with all of them returning to their work/sports successfully. The functional outcome according to constant score was above 80 in 90% cases. Conclusion:Surgical fixation of lateral-third clavicle fractures with a hook plate is an effective technique resulting in excellent rate of union and relatively good functional outcome.