Asadollahi S, et al. - A systematic search of electronic databases was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline by the researchers in order to contrast the outcome of hook plate fixation with other techniques in surgical fixation of acute unstable distal clavicle fractures. Eleven studies were ascertained that met the inclusion criteria with 634 patients. There were 397 and 237 male and female, respectively. No important variation between the functional outcome and union rate between hook plate fixation, coracoclavicular (CC) stabilization, and locking plate fixation was found. In comparison with tension band wiring (TBW), hook plate fixation led to a higher Constant–Murley score. In contrast with CC stabilization and the locking plate, it had a correlation with a higher complication rate. Hook plate fixation was related to a lower complication rate, compared with TBW. Hence, in comparison with CC stabilization and locking plate fixation, hook plate fixation attained a comparable functional outcome and union rate. Nevertheless, it had a superior functional outcome vs TBW. Moreover, the complication rate was higher compared with CC stabilization and locking plate fixation and was lower compared with TBW.