Background: The operative treatment for distal clavicle fracture using Clavicle Hook Plate (CHP) has been reported to be promising in the literature, however, controversy regarding the restriction in shoulder elevation till the removal of implant still exists in fact. In this study we assessed the postoperative outcome of surgical treatment with CHP for distal clavicle fracture.
Methods: Ten patients with distal clavicle fracture treated with CHP between 2008 and 2010 were retrospectively reviewed. The average age at the time of operation was 42.7 years old (17 to 64), and the mean follow-up period was 7.65 months (6 to 11). Post-operative physiotherapy was started with pendulum motion, followed by active and passive range of motion exercise confined in elevation up to 90 degree until the removal of the plate was done. In terms of the clinical evaluation, range of motion (ROM), Japan Orthopedics Association shoulder score (JOA score), subacromial clear zone on x-ray and complications related to CHP were investigated.
Results: With regard to ROM, mean flexion / abduction before removal of CHP were 97.5°/ 91.3°, respectively. At the final check-up. The average flexion / abduction were improved to 150°/ 144°, respectively . Post-operative JOA score at the last observation was 86.2 points. Eight cases (80%) showed subacromional clear zone, however, cut-out of acromion was not observed in this study. One patient showed implant back-out and another showed re-fracture after removal of the implant.
Conclusion: Although post-operative restriction in shoulder elevation might induce contracture, ROM was recovered very soon after the removal of CHP with physiotherapy.
