Abstract: Background & Objectives: Clavicle fracture is the commonest fracture amongst adults and roughly a quarter of all clavicle fractures occur at the lateral end
[1]. These fractures are unstable due to the various deforming forces which act on the fragments as well as the small distal fracture fragment. At most times the deforming forces are not taken into consideration, and the fracture is not fixed securely. In this study, we assessed a fixation technique using the lateral end clavicle hook plates to find out whether it provided a stable fixation with good functional outcome.
Methods: This study is a prospective, hospital based study conducted in Anil Neerukonda Hospital and NRI Institute of Medical Sciences, Visakhpatnam, between May 2018 to May 2021. The fractures were classified according to Neer’s classification and were followed up at regular intervals.In total, 12 patients with lateral end clavicle fracture (Neer's Type II) were included in the study. After the informed consent and preoperative investigations were obtained, open reduction and internal fixation was done using a 3.5 mm lateral end clavicular hook plate under regional anesthesia. Postoperative X-rays were done on day 1 and every 6 weeks after operation, until radiological union was achieved. The postoperative pain was assessed using Visual Analogue Scale (VAS) on postoperative days 1, 2 and 10. Postoperatively arm pouch sling was given for 10 days followed by active mobilization. Patients were asked to do their daily routine work and avoid lifting heavy weights. The functional outcome was assessed at the end of 2nd and 6th months with the help of Disabilities of the Arm, Shoulder and Hand (DASH) scoring.
Results: There were no intraoperative complications in the procedure. The mean VAS score on postoperative day 1 was found to be 5 which decreased to 3 on day 2 and 0 on day 10. The mean DASH score was calculated as 10.58 at the end of postoperative month 2 and then 4.2 at the end of month 6. There was one case of superficial infection which was resolved with local debridement, there was initial restriction of overhead abduction in this case but was not painful and was managed conservatively.
Conclusion: Lateral end clavicular hook plate is a good fixation system for lateral end clavicle fractures. Operative time is reduced and surgical dissection is minimum. Device provides good angular stability and helps in early mobilization. It may well be the answer to the fixation questions of the lateral clavicle fractures, although larger comparative studies between the surgical treatment methods are required to confirm the same.
