الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Operative treatment of patients with displaced lateral clavicle fractures with the hook plate has produced good short term as well as mid-term results. Using this plate may cause impingement and subacromial osteolysis, without leading to functional impairment. These complications can be minimized by meticulously adjusting the plate to the individual anatomy with verification under fluoroscopy and/or arthroscopy. A second operation is needed to remove the plate after fracture consolidation. In the short term follow up after plate removal, impingement complaints and the osteolysis disappear. In this study we found no relation between these short term complications and mid-term functional results.
We conclude that clavicle hook plate fixation is a good primary treatment for the displaced lateral clavicle fracture. It facilitates early mobilization of the shoulder postoperatively and results in a high percentage of union with a good objective and subjective shoulder function. Part of the treated patients do develop impingement symptoms due to a mismatch between the plate and patient anatomy, one of the reasons the plate has to be removed after fracture consolidation. Mid-term follow up shows no additional damage done to the surrounding structures that can be addressed to the use of this plate.
In summary, the AO hook plate results in a high union rate with a good return of function. We advocate contouring the plate at the time of the surgery and removal of all metalwork at 4 months. We do not recommend its use in the osteoporotic bone. This is a small series and a larger number of patients are required to lend statistical support to the merits of this technique. Nevertheless, the high union rates
and the excellent short-to-medium term function scores are very encouraging and the use of the AO hook plate is now our preferred method of management of the displaced lateral third clavicle fractures.