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The Radiologic Comparison of Operative Treatment Using a Hook Plate versus a Distal Clavicle Locking Plate of Distal Clavicle Fracture
Clinics in Shoulder and Elbow 2018;21:227-233
Published online December 1, 2018
© 2018 Korean Shoulder and Elbow Society.

Byungil Yoon, Jae Yoon Kim, Jae-Sung Lee, Hyoung Seok Jung

Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul, Korea
Correspondence to: Jae Yoon Kim
Department of Orthopaedic Surgery, Chung-Ang University Hospital, 102 Heukseok-ro, Dongjak-gu, Seoul 06973, Korea
Tel: +82-2-6299-1592, Fax: +82-2-1800-1114, E-mail: kjycje@gmail.com, ORCID: https://orcid.org/0000-0001-8099-1366
IRB approval: Chung-Ang University Hospital (IRB No. 1807-005-16186).
Received June 15, 2018; Revised September 20, 2018; Accepted September 21, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Background: The purpose of this study was to compare the radiologic results of patients who underwent surgery with a hook plate and a locking plate in distal clavicle fractures.
Methods: Sixty patients underwent surgical treatment for Neer type IIa, IIb, III, and V distal clavicle fracture. Twenty-eight patients underwent fracture fixation with a hook plate and 32 with a locking plate. Coracoclavicular distance was measured on standard antero-posterior radiographs before and after the surgery, and union was confirmed by radiograph or computed tomography taken at 6 months postoperatively. Other radiologic complications like osteolysis was also checked. 
Results: Bony union was confirmed in 59 patients out of 60 patients, and 1 patient in the hook plate group showed delayed union. Coracoclavicular distance was decreased more in the hook plate group after surgery (p<0.01). After 6 weeks of the hook plate removal, the coracoclavicular distance was increased a little compared to before metal removal, but there was no difference compared to the contralateral shoulder. Eleven out of 28 patients (39.3%) showed osteolysis on the acromial undersurface in the hook plate group.
Conclusions: Both the hook plate group and the locking plate group showed satisfactory radiologic results in distal clavicle fractures. Both hook plate and locking plate could be a good treatment option if it is used in proper indication in distal clavicle fracture with acro-mioclavicular subluxation or dislocation. 
Keywords : Clavicle; Bone plates; Open fracture reductio