Midshaft clavicle fracture following osteosynthesis with a hook plate: a retrospective case analysis
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TRAUMA SURGERY
Midshaft clavicle fracture following osteosynthesis with a hook plate: a retrospective case analysis Jen‑Ta Shih1 · Chia‑Chun Wu1 · Chih‑Chien Wang1 · Tsu‑Te Yeh1 · Ru‑Yu Pan1 · Chien‑Lung Chen2 · Wu‑Chien Chien3 · Pei‑Hung Shen1 Received: 25 October 2019 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose The clavicle hook plate has been commonly used to treat distal clavicle fractures and acromioclavicular (AC) joint dislocations; however, midshaft clavicle fracture at the medial end of the hook plate remains an underestimated complication. We aimed to discover the risk factors for this complication and the influence of these risk factors on patients and to suggest preventive surgical techniques. Methods We retrospectively reviewed the records of 150 patients with acute distal clavicle fractures or acute AC joint dislocations treated by internal fixation with a clavicle hook plate. The patient demographics, the occurrence of midshaft clavicle fracture at the medial end of the hook plate, and functional outcomes were analyzed. The functional outcomes were evaluated with the American Shoulder and Elbow Surgeons (ASES) Shoulder Score and grading of the Constant shoulder score after the hook plate was removed. Results In total, 17 patients had complicating midshaft clavicle fractures at the medial end of the hook plate. Elderly patients had a higher risk of developing this complication than young patients. The odds ratio was 4.4 (p
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