Cases Report: Clavicular Fractures after Hook-Plate Fixation Surgery

Abstract

The clavicular hooked plate had been used worldwide for fixation the unstable fracture of the distal clavicle and displaced acromioclavicular joint dislocation.  Although it has been widely accepted as the new device used, some complications were still present. The reported complications include acromion fracture, clavicle fracture at the medial end of the hook plate, recurrent acromioclavicular joint subluxation, disengagement of plate as well as subacromial pain and impingement. There were few reports about complications after hook plate fixation surgery. The present study reported 2 cases of clavicle fracture at the medial end of the hook plate after the operation. The first case was diagnosed with displaced fracture at distal end of right clavicle (Neer type II) and the second case was diagnosed with displaced right acromioclavicular joint (Rockwood type IV).  All fracture lines were initiated beneath the medial end of hook plate and adjacent to medial screw which indicated a weak point. Additionally, the stress at the medial end of the hook plate was increased. Both patients were received conservative treatment and were not performed re-fixation surgery. They achieved clavicle union with a good functional result.