Comparison of the efficacy of hook plate versus tension band wire in the treatment of unstable fractures of the distal clavicle.

Fifty-two patients with unstable fractures of distal clavicle treated by open reduction and internal fixation with hook plates or tension band wires were retrospectively reviewed. The 52 patients were divided into two groups based on the method of treatment. The hook plate (HP) group included 32 patients and the tension band wire (TBW) group included 20 patients. Both groups were similar in respect to injury mechanisms, compounding medical conditions, and shoulder score (p > 0.1). However, hook plating had a significantly lower rate of complication (p = 0.01) and symptomatic hardware (p = 0.001). In addition, hook plating better facilitated the return to work and athletic activity (p = 0.004 and p = 0.003, respectively). In conclusion, if surgery of distal clavicular fractures is indicated, internal fixation with a hook plate has more advantages than with tension band wires.