New Surgery 08 18 2009

Clavicle Hook Plate 

Technique Guide 

Original Instruments and Implants of the Association 

for the Study of Internal Fixation—AO/ASIF

Overview 

The Clavicle Hook Plate provides a single solution for 

fixation of both lateral clavicle fractures and 

acromioclavicular joint injuries. This plate and screw 

construct allows early rotational mobility of the shoulder. 

Indications 

The Clavicle Hook Plate is 

indicated for: 

•Lateral clavicle fractures 

•Dislocations of the 

acromioclavicular joint 

Lateral clavicle fracture 

Dislocation of the acromioclavicular joint

Clavicle Hook Plates 

Features 

•Dynamic compression screw holes accept 

3.5 mm cortex and 4.0 mm cancellous 

bone screws 

•Compatible with the 3.5 mm DCP®Drill Guide 

[322.32] or the 3.5 mm Universal Drill Guide 

[323.36] 

•Anterolateral screw hole provides additional options 

for screw fixation in the lateral clavicle 

•Hook provides additional support to both lateral 

clavicle fractures and acromioclavicular 

joint dislocations 

•Plates available with 6 or 8 holes 

•15 mm and 18 mm hook depths 

accommodate patient anatomy 

•Precontoured in left and right plates 

•Available in commercially pure (CP) titanium or 

316L stainless steel 

•Offset hook design to avoid insertion of 

hook into acromioclavicular ligament 

241.064 

441.067 

1

Surgical Technique 

2 

Lateral Clavicle Fractures 

Incision 

Through a standard surgical incision, taking care 

not to disrupt the surrounding soft tissues, expose 

the outermost part of the clavicle, the fracture site, 

and the acromioclavicular joint. 

Insertion 

Perform temporary fixation of the fracture using 

Kirschner wires or bone holding forceps. Dissect 

the soft tissue, posterior to the acromioclavicular 

joint, to prepare a path for the insertion of the 

hook. Using the plate with 15mm hook depth, pass 

the hook under the acromion. Place the shaft of the 

plate onto the superior aspect of the clavicle. If 

there is difficulty lowering the plate shaft onto the 

clavicle, then the plate with 18 mm hook depth 

should be used. Once the plate shaft is placed on 

the clavicle, the end of the hook should be in 

contact with the underside of the acromion. 

Confirm that the correct anatomic alignment of the 

clavicle and acromion has been restored without 

impingement of the rotator cuff. Also before 

fixation, use the c-arm to verify that full shoulder 

motion, particularly in abduction and external 

rotation, can be achieved without impingement of 

the humeral head on the hook. 

Fixation 

One or two screws (either 3.5 mm cortex or 

4.0mm cancellous bone screws) can be placed in 

the lateral plate holes. The position and angulation 

of the screws depends on the fracture configuration. 

The 3.5 mm cortex screws placed in the medial 

plate holes can be positioned eccentrically 

depending on the fracture configuration, to provide 

dynamic compression of the fracture fragments. 

3 

2 

1

3 

Incision 

Through a standard surgical incision, taking care 

not to disrupt the soft tissues, expose the acromio- 

clavicular joint and the lateral shaft of the clavicle. 

Insertion 

Push down on the clavicle to reduce the dislocation 

of the acromioclavicular joint and provide 

temporary fixation using Kirschner wires. Dissect 

the soft tissue, posterior to the acromioclavicular 

joint, to prepare a path for the insertion of the 

hook. Perform any ligament or capsule repairs. 

Using the plate with 15 mm hook depth, pass the 

hook under the acromion. Place the plate on the 

superior aspect of the clavicle and confirm that the 

correct anatomic alignment of the clavicle and 

acromion has been restored. If the realignment 

appears to be overcorrected, use the plate with 

18mm hook depth. Before fixation use the c-arm 

to verify that full shoulder motion, particularly in 

abduction and external rotation, can be achieved 

without impingement of the humeral head on 

the hook. 

Fixation 

If sutures are used to repair the ligaments, the 

sutures can be passed through the lateral hole(s) 

of the plate and tied under tension to provide 

additional stability to the acromioclavicular joint. 

Place 3.5 mm cortex or 4.0 mm cancellous bone 

screws in the medial plate holes. Tighten the 

screws, ensuring that the acromioclavicular joint is 

reduced and stable. 

3 

2 

1 

Dislocation of the Acromioclavicular Joint

4 

3.5 mm Clavicle Hook Plates 

RIGHT LEFT HOLES HOOK DEPTH MATERIAL 

241.062 241.063 6 15 mm Stainless Steel 

241.064 241.065 6 18 mm Stainless Steel 

241.066 241.067 8 15 mm Stainless Steel 

241.068 241.069 8 18 mm Stainless Steel 

RIGHT LEFT HOLES HOOK DEPTH MATERIAL 

441.062 441.063 6 15 mm Titanium 

441.064 441.065 6 18 mm Titanium 

441.066 441.067 8 15 mm Titanium 

441.068 441.069 8 18 mm Titanium 

Removal of the Implant 

Caution 

It is recommended that the Clavicle Hook Plate be 

removed after healing to prevent potential irritation 

of the acromion or impingement of the rotator cuff. 

241.064 

441.067