Clavicular Hook Plate Removal: A Necessity or A Myth?

Clavicular Hook Plate Removal

Authors

  • Uzair Rashid Department of Orthopedic, Ghurki Trust Teaching Hospital, Lahore, Pakistan
  • Abdulah Wali Department of Orthopedic, Ghurki Trust Teaching Hospital, Lahore, Pakistan
  • Saad Ilyas Department of Orthopedic, Ghurki Trust Teaching Hospital, Lahore, Pakistan
  • Ijaz Ahmed Department of Orthopedic, Gurki Trust Teaching Hospital, Lahore, Pakistan
  • Humera Rafiq Department of Pathology, Fatima Jinnah Medical University, Lahore, Pakistan
  • Arsala Rashid Department of Hematology, Services Institute of Medical Sciences, Lahore, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v6i6.3381

Keywords:

Clavicular Fracture, Acromioclavicular Joint Dislocation, Hook Plate Removal, Timely fixation

Abstract

Timely fixation of fractures of the clavicle or acromioclavicular joint dislocation is rising in popularity vs conservative management. This is primarily due to potential complications, such as impingement, which may result in chronic pain and limited shoulder mobility. Objectives: To find the cause and number of hardware removals among clavicular fractures. To assess whether clavicular plates caused any after effects when they were left in. Methods: A Total of 156 patients treated by hook plate for either fracture of distal clavicular fracture or treatment of acromioclavicular joint dislocation were enrolled from January 2024 to April 2024 in the Orthopedic Department of Gurki Trust Teaching Hospital. All patients were followed for 12 months postoperatively. Clinical results were gauged using different scores. Results: There were 107 male and 49 female. At follow up patients in group I were n=50 (64.5%), while group II had only n=15 (19.2%) patients who underwent hook plate removal. The pain VAS scale had a significant p-value of 0.0035 among both groups. The SST score was statistically significant with a p-value of 0.0026. On the last follow-up visit, the mean VAS, SST, and Constant-Murley scores had insignificant p-values, respectively, in both groups. Conclusions: Clavicular fracture or acromioclavicular joint dislocation fixation by using hook plates is a safe and reliable mode of treatment.  Patients operated with hook plates for distal clavicular fractures are more comfortable, while those treated for acromioclavicular joint dislocation are keener for its removal.

References

Mayasari DA, Hawari I, Dwiyanti SA, Noviyadi NR, Andryani DS, Utomo MS et al. Convolutional Neural Network for Assisting Accuracy of Personalized Clavicle Bone Implant Designs. International Journal of Electrical and Computer Engineering. 2024 Jun; 14(3): 3208-19. doi: 10.11591/ijece.v14i3.pp3208-3219. DOI: https://doi.org/10.11591/ijece.v14i3.pp3208-3219

Minkus M, Wieners G, Maziak N, Plachel F, Scheibel M, Kraus N. The Ligamentous Injury Pattern in Acute Acromioclavicular Dislocations and Its Impact on Clinical and Radiographic Parameters. Journal of Shoulder and Elbow Surgery. 2021 Apr; 30(4): 795-805. doi: 10.1016/j.jse.2020.10.026. DOI: https://doi.org/10.1016/j.jse.2020.10.026

Von Rüden C, Rehme-Röhrl J, Augat P, Friederichs J, Hackl S, Stuby F et al. Evidence on Treatment of Clavicle Fractures. Injury. 2023 Oct; 54: 110818. doi: 10.1016/j.injury.2023.05.049. DOI: https://doi.org/10.1016/j.injury.2023.05.049

Fitzgerald EM, Moore DM, Quinlan JF. A Review of Outcomes After Operative Fixation of Clavicular Fractures Over A 10-Year Period—A Single Tertiary Trauma Unit Experience. Journal of Shoulder and Elbow Surgery International. 2022 Mar; 6(2): 264-7. doi: 10.1016/j.jseint.2021.11.001. DOI: https://doi.org/10.1016/j.jseint.2021.11.001

Mast J, Van Beek N, Claes T. Fast Rehab After Midshaft Clavicula Fractures in Elite Cyclists and Motocross Riders. Acta Orthopedica Belgica. 2023 Sep; 89: 525-30. doi: 10.52628/89.3.11696. DOI: https://doi.org/10.52628/89.3.11696

Kumar MK and Mylarappa A. A Comparative Study on Fixation of Unstable Lateral End Clavicle Fractures with Tightrope and Endobutton by Transcoracoid and Subcoracoid Cerclage Techniques. Journal of Orthopedics, Traumatology and Rehabilitation. 2024 Jul; 16(2): 107-12. doi: 10.4103/jotr.jotr_6_24. DOI: https://doi.org/10.4103/jotr.jotr_6_24

Patel R, Khan MM, Gibson W, Banerjee R, Pardiwala A. Comparison of Hook Plates Vs. Locking Plates for Neer Type IIB Fractures of Lateral End Clavicle: A Systematic Review. Chinese Journal of Traumatology. 2025 Feb. doi: 10.1016/j.cjtee.2024.03.012. DOI: https://doi.org/10.1016/j.cjtee.2024.03.012

Chen PH, Chen CY, Lin KC, Tarng YW. Fixing Cho Type IIC Distal Clavicle Fractures with Hook Plates Leads to a High Incidence of Subacromial Osteolysis: A Retrospective Study and Literature Review. Clinics in Orthopedic Surgery. 2024 Sep; 16(5): 694. doi: 10.4055/cios24009. DOI: https://doi.org/10.4055/cios24009

Testa EJ, Katz L, Zhang H, Chang K, Kutschke MJ, Dworkin M et al. Rotator Cuff Tears to Shoulder Instability: The Relationship Between Acromial Morphology and Shoulder Pathology. Journal of Bone and Joint Surgery Reviews. 2024 Jan; 12(1): e23. doi: 10.2106/JBJS.RVW.23.00188. DOI: https://doi.org/10.2106/JBJS.RVW.23.00188

Saengsirinavin P, Iamsirikulmit C, Piyapittayanun P, Phiphobmongkol V, Jongthanakamol T, Ratanalekha R. Optimizing Hook Implantation Angle of the Clavicular Hook Plate: A Cadaveric Study. European Journal of Orthopedic Surgery and Traumatology. 2024 Jul; 34(5): 2653-61. doi: 10.1007/s00590-024-03981-z. DOI: https://doi.org/10.1007/s00590-024-03981-z

Choi JH, Chun YM, Yoon TH. Effect of Cigarette Smoking on the Maintenance of Reduction After Treatment of Acute Acromioclavicular Joint Dislocation with Hook Plate Fixation. Clinics in Shoulder and Elbow. 2023 Nov; 26(4): 373. doi: 10.5397/cise.2023.00738. DOI: https://doi.org/10.5397/cise.2023.00738

Xu D, Luo P, Chen J, Ji L, Yin L, Wang W et al. Outcomes of Surgery for Acromioclavicular Joint Dislocation Using Different Angled Hook Plates: A Prospective Study. International Orthopedics. 2017 Dec; 41(12): 2605-11. doi: 10.1007/s00264-017-3611-2. DOI: https://doi.org/10.1007/s00264-017-3611-2

Javed H, Olanrewaju OA, Owusu FA, Saleem A, Pavani P, Tariq H, Ortiz BS, Ram R, Varrassi G. Challenges and Solutions in Postoperative Complications: A Narrative Review in General Surgery. Cureus. 2023 Dec; 15(12). doi: 10.7759/cureus.50942. DOI: https://doi.org/10.7759/cureus.50942

Shaty W. The Results of Hook Plate Fixation in Acute Acromioclavicular Joint Dislocation and Distal Clavicle Fractures. Orthopedic Reviews. 2024 Jun; 16: 120306. doi: 10.52965/001c.120306. DOI: https://doi.org/10.52965/001c.120306

Maliwankul K, Kanyakool P, Klabklay P, Parinyakhup W, Boonriong T, Chuaychoosakoon C. Progressive Loss of Acromioclavicular Joint Reduction Correlated with Progressive Clavicular Tunnel Widening after Coracoclavicular Stabilization in Acute High-Grade Acromioclavicular Joint Injury. Journal of Clinical Medicine. 2024 Jul; 13(15): 4446. doi: 10.3390/jcm13154446. DOI: https://doi.org/10.3390/jcm13154446

Martetschläger F and Zampeli F. What to Do If It Goes Wrong? Solutions After Failure. In ESSKA Instructional Course Lecture Book: Milan. Berlin, Heidelberg: Springer Berlin Heidelberg 2021. 2020 Apr 25: 175-181. doi: 10.1007/978-3-662-61264-4_25. DOI: https://doi.org/10.1007/978-3-662-61264-4_25

Kashii M, Inui H, Yamamoto K. Surgical Treatment of Distal Clavicle Fractures Using the Clavicular Hook Plate. Clinical Orthopedics and Related Research (1976-2007). 2006 Jun; 447: 158-64. doi: 10.1097/01.blo.0000203469.66055.6a. DOI: https://doi.org/10.1097/01.blo.0000203469.66055.6a

Thangaraju S, Tauber M, Habermeyer P, Martetschläger F. Clavicle and Coracoid Process Periprosthetic Fractures as Late Post-Operative Complications in Arthroscopically Assisted Acromioclavicular Joint Stabilization. Knee Surgery, Sports Traumatology, Arthroscopy. 2019 Dec; 27(12): 3797-802. doi: 10.1007/s00167-019-05482-7. DOI: https://doi.org/10.1007/s00167-019-05482-7

Reska M, Konečný J, Kašpar M, Kábela M, Cierník J. Stabilization of the Dislocated Acromioclavicular Joint and Lateral Fractures of the Clavicle Using a Hook Plate. Rozhledy v Chirurgii: Mesicnik Ceskoslovenske Chirurgicke Spolecnosti. 2013 Mar; 92(3): 143-50.

Oh JH, Min S, Jung JW, Kim HJ, Kim JY, Chung SW et al. Clinical and Radiological Results of Hook Plate Fixation in Acute Acromioclavicular Joint Dislocations and Distal Clavicle Fractures. Clinics in Shoulder and Elbow. 2018 Jun; 21(2): 95. doi: 10.5397/cise.2018.21.2.95. DOI: https://doi.org/10.5397/cise.2018.21.2.95

Louwerens JK, van den Bekerom MP, van Royen BJ, Eygendaal D, van Noort A, Sierevelt IN. Quantifying the Minimal and Substantial Clinical Benefit of the Constant-Murley Score and the Disabilities of the Arm, Shoulder and Hand Score in Patients with Calcific Tendinitis of the Rotator Cuff. Journal of Bone and Joint Surgery International. 2020 Sep; 4(3): 606-11. doi: 10.1016/j.jseint.2020.05.001. DOI: https://doi.org/10.1016/j.jseint.2020.05.001

Hendrickx E. Patient-Specific Implant to Treat Displaced Acromial Stress Fractures After Reverse Total Shoulder Arthroplasty (Doctoral dissertation, Ghent University). 2021.

Downloads

Published

2025-06-30
CITATION
DOI: 10.54393/pjhs.v6i6.3381
Published: 2025-06-30

How to Cite

Rashid, U., Wali, A., Ilyas, S., Ahmed, I., Rafiq, H., & Rashid, A. (2025). Clavicular Hook Plate Removal: A Necessity or A Myth? Clavicular Hook Plate Removal. Pakistan Journal of Health Sciences, 6(6), 289–293. https://doi.org/10.54393/pjhs.v6i6.3381

Issue

Section

Original Article

Plaudit