Clinical and Radiological Results of Hook Plate Fixation in Acute Acromioclavicular Joint Dislocations and Distal Clavicle Fractures

Abstract

BACKGROUND: The purpose of this study was to evaluate the clinical outcomes and complications of hook plate fixation in acromioclavicular (AC) joint dislocations and distal clavicle fractures.METHODS: We retrospectively reviewed a series of 60 consecutive patients with hook plate fixation for AC joint dislocation (group I) and distal clavicle fracture (group II). Groups I and II had 39 and 21 patients, respectively. Clinical results were evaluated using the pain visual analogue scale (VAS), simple shoulder test, and Constant-Murley scores. In addition, subacromial erosion and stiffness were evaluated as complications.RESULTS: At the removal, the pain VAS was 2.69 ± 1.30 and 4.10 ± 2.14 in groups I and II, respectively, which were significantly different (p=0.003). The simple shoulder test score was 9.59 ± 1.60 and 7.81 ± 2.67 in groups I and II, respectively, which were also significantly different (p=0.002). Subacromial erosion was significantly more frequent in group II (14/21 patients, 66.7%) than in group I (15/39 patients, 38.5%) (p=0.037), and stiffness was also higher in group II (17/21 patients, 81.0%) than in group I (22/39 patients, 56.4%), but it was not significant.CONCLUSIONS: Hook plate fixation showed good clinical and functional results for the treatment of acute unstable AC joint dislocation and distal clavicle fracture. But, in distal clavicle fractures, there are more subacromial erosion and stiffness compare with acute unstable AC joint dislocation.

Effect of subacromial erosion shape on rotator cuff and clinical outcomes after hook plate fixation in type 5 acromioclavicular joint dislocations: a retrospective cohort study

“…Although the hook plate showed good clinical results, subacromial erosion was observed at a relatively high frequency after surgery [ 4 , 10 , 12 ]. Oh et al reported that 38% (15/39) of patients treated for AC joint dislocations with hook plate fixation showed subacromial erosion [ 19 ]. Lee et al reported that there were no significant differences in clinical and radiological results between patients with ( n = 18) and without ( n = 34) subacromial erosion after AC joint dislocation treatment with hook plate fixation [ 15 ].…”

Complications and Frequency of Surgical Treatment with AO-Type Hook Plate in Shoulder Trauma: A Retrospective Study

“…Although numerous surgical methods have been introduced for cases requiring surgical treatment in these two types of acute shoulder trauma, the comparative advantage of each method is controversial [5][6][7][8][9]. Among the various surgical modalities reported, AO-type hook plate fixation has been an effective alternative plate fixation method for unstable DCF and severe ACD and has been used to promote the natural healing of ligaments [9][10][11][12][13]. The design of the AO-type hook plate is interesting because the hook passes below the acromion posterior to the acromioclavicular joint; therefore, it does not interfere with the joint.…”

Are Hook Plate Complications Inevitable?

“…Sim et al 9) reported erosion in 62% of their cases, whereas Kim et al 10) reported the incidence in all cases. Oh et al 11) observed subacromial erosion in AC joint dislocation and distal clavicle fractures, with significantly greater frequency in the group of distal clavicle fracture (66.7%) than in AC joint dislocation (56.4%). However, in the study by Oh et al, 11) the hook plate was removed earlier in the AC joint dislocation group (mean, 5.31 months) than in the distal clavicle fracture group (mean, 9.65 months).…”

“…Oh et al 11) observed subacromial erosion in AC joint dislocation and distal clavicle fractures, with significantly greater frequency in the group of distal clavicle fracture (66.7%) than in AC joint dislocation (56.4%). However, in the study by Oh et al, 11) the hook plate was removed earlier in the AC joint dislocation group (mean, 5.31 months) than in the distal clavicle fracture group (mean, 9.65 months). The difference in the duration from surgery to removal could affect the incidence or severity of the complication arising due to hook plate.…”