Short-term outcomes of arthroscopic TightRope® fixation are better than hook plate fixation in acute unstable acromioclavicular joint dislocations

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.

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Comparison of Results between Hook Plate Fixation and Ligament Reconstruction for Acute Unstable Acromioclavicular Joint Dislocation

Clinics in Orthopedic Surgery ◽

10.4055/cios.2015.7.1.97 ◽

2015 ◽

Vol 7 (1) ◽

pp. 97 ◽

Cited By ~ 24

Author(s):

Jong Pil Yoon ◽

Byoung-Joo Lee ◽

Sang Jin Nam ◽

Seok Won Chung ◽

Won-Ju Jeong ◽

...

Keyword(s):

Ligament Reconstruction ◽

Acromioclavicular Joint ◽

Plate Fixation ◽

Hook Plate ◽

Acromioclavicular Joint Dislocation ◽

Joint Dislocation ◽

Comparison Of Results

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Hook-Plate Fixation in Patients with Acute Acromioclavicular Joint Dislocation Improved Radiographic But Not Clinical Outcomes Compared with Nonoperative Treatment

The Journal of Bone and Joint Surgery (American) ◽

10.2106/jbjs.16.00582 ◽

2016 ◽

Vol 98 (16) ◽

pp. 1405 ◽

Cited By ~ 1

Author(s):

Charles L. Cox

Keyword(s):

Clinical Outcomes ◽

Acromioclavicular Joint ◽

Plate Fixation ◽

Nonoperative Treatment ◽

Hook Plate ◽

Acromioclavicular Joint Dislocation ◽

Joint Dislocation

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Subacromial Erosion after Hook Plate Fixation in Acute Acromioclavicular Joint Dislocation

10.21203/rs.3.rs-125960/v1 ◽

2020 ◽

Author(s):

Jung Youn Kim ◽

Yong Girl Rhee ◽

Young Wan Ko ◽

Sung Min Rhee

Keyword(s):

Risk Factors ◽

Computed Tomography ◽

Acromioclavicular Joint ◽

Plate Fixation ◽

Hook Plate ◽

Unaffected Side ◽

Ct Findings ◽

Ucla Score ◽

The Mean

Abstract Background: This study was to analyze the clinical results of locking hook plate fixation for acute acromioclavicular joint (ACJ) injury and to find out the incidence of subacromial erosion, carry out quantitative analysis and identify risk factors. Methods: The study was conducted on 35 patients who underwent the locking hook plate fixation for acute ACJ joint injury. The clinical outcomes were evaluated measuring the visual analog scale (VAS) for pain, and the University of California at Los Angeles (UCLA) score. The computed tomography (CT) was conducted to measure the subacromial erosion. The acromioclavicular slope (AC slope) of the unaffected side, the acromion-hook angle (AH angle), the acromioclavicular anteroposterior distance (AC-AP distance), and the preoperative acromioclavicular interval (ACI) of the affected side were analyzed to identify the risk factors of subacromial erosion. Results: The mean preoperative VAS score was 7.6 points, which improved by a significant level of 0.3 at the final follow-up (P <0.001). The UCLA score at the last follow-up was 32.3 points, which was higher than the preoperative average of 15.2 points (P = 0.003). According to the computed tomography (CT) findings, subacromial erosion was found in all cases, and the mean value was 5.0mm, which is 53% of the entire acromion thickness. The AC slope (B=-0.159, P<0.001) and AC-AP distance (B=0.233, P=0.004) were found to have a significant influence on postoperative subacromial erosion. The AC slope showed a negative correlation with the amount of erosion, while the AC-AP distance showed a positive correlation with erosion. onclusion: The study was able to obtain satisfactory clinical and radiological results after locking hook plate fixation for acute ACJ injury. The CT findings revealed that subacromial erosion occurred in all cases, and the mean erosion depth was about 50% of the acromial thickness. If the preoperative AC slope of the unaffected side was more acute and the AC-AP distance was larger, the incidence of subacromial erosion was higher. Level of evidence: Therapeutic Level IV Retrospectively registered study: This study was retrospective in nature, and final approval of informed consent exemption by the institutional review board was obtained (KHUH IRB 2019-04-079)

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Crossbar Technique for the Failed Clavicular Hook Plate Fixation in an Acute Acromioclavicular Joint Dislocation: Salvage for Acromial Fracture after Clavicular Hook Plate

Clinics in Shoulder and Elbow ◽

10.5397/cise.2019.22.3.149 ◽

2019 ◽

Vol 22 (3) ◽

pp. 149-153

Author(s):

Kyoung Hwan Koh ◽

Dong Ju Shin ◽

Seong Mun Hwang

Keyword(s):

Acromioclavicular Joint ◽

Plate Fixation ◽

Hook Plate ◽

Acromioclavicular Joint Dislocation ◽

Salvage Procedure ◽

Subsequent Fracture ◽

Ligament Augmentation ◽

Clavicular Hook Plate ◽

Acromial Fracture ◽

Type V

We experienced acromial erosion and subsequent fracture after the treatment of Rockwood type V acromioclavicular dislocation with hook plate and coracoclavicular ligament augmentation. It was treated by using a surgical technique to address an acromial fracture and subsequent losses of reduction in acromioclavicular joint with two trans-acromial cortical screws (crossbar technique). The reduction state of acromioclavicular joint could be maintained by these two screws. Our crossbar technique could be considered as a good salvage procedure for the reduction loss caused by cutout or significant erosion of acromion after insertion of clavicular hook plate.

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