The Efficacy of Hook Plates Around the Elbow: A Stable Fixation

Hook plates are low-profile implants commonly used for olecranon fractures and osteotomies, offering stable fixation especially in complex or osteoporotic fractures. This study evaluates the clinical and functional outcomes of hook plate fixation around the elbow. We retrospectively analyzed 20 patients (mean age 52.7 years) treated between 2016 and 2023 for olecranon or distal humerus fractures using hook plates alone or combined with other implants. Inclusion criteria were patients aged 16 years or older with at least 12 months of follow-up. Exclusion criteria included ASA ≥ IV, open fractures, or involvement of the humeral head or wrist. Radiographic and clinical follow-up included elbow range of motion and validated functional outcome scores: Mayo Elbow Performance Score (MEPS), Oxford Elbow Score (OES), and Disabilities of the Arm, Shoulder and Hand (DASH). Fracture types included 10 olecranon, 9 distal humerus, and 1 combined injury. At a mean follow-up of 18 months, mean elbow flexion was 124.0°, with a mean extension deficit of 22.0°. Functional scores were: MEPS 77.8, OES 47.5, and DASH 50.7. One patient developed a postoperative fracture-related infection treated successfully with irrigation and hardware retention, while another experienced transient ulnar nerve symptoms that resolved spontaneously. No cases of heterotopic ossification were observed. These findings suggest that hook plate fixation around the elbow provides stable fixation with low complication rates and favorable functional outcomes. Further studies with larger sample sizes are necessary to confirm these findings.