scholarly journals 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

2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Ho-Seok Oh ◽  
Sungmin Kim ◽  
Jeong-Hun Hyun ◽  
Myung-Sun Kim
Keyword(s):  
Rotator Cuff ◽  
Clinical Outcomes ◽  
Plate Fixation ◽  
Hook Plate ◽  
Ac Joint ◽  
Plate Removal ◽  
Joint Dislocations ◽  
Rotator Cuff Lesions ◽  
Surgical Fixation

Abstract Background Surgical fixation using hook plates is widely used in the treatment of acromioclavicular (AC) joint dislocations. The purpose of this study was to evaluate the incidence and shape of subacromial erosions after removal of the hook plate in type 5 AC joint dislocations. Further, we evaluated the effect of the shape of the subacromial erosion on the rotator cuff. Methods We retrospectively reviewed 30 patients who underwent hook plate fixation for type 5 AC joint dislocations at our hospital between December 2010 and December 2018. Patients with a follow-up of at least 1 year were included. Clinical outcomes were assessed using the final follow-up Constant-Murley, Korean Shoulder, and visual analog scores. To ensure that the appropriate reduction was well maintained, the coracoclavicular distances of the injured and contralateral sides were evaluated at the last follow-up. Computed tomography was performed to investigate the presence and shape of the subacromial erosion after hook plate removal at 4 months after surgery. Ultrasonography was performed to investigate the presence of rotator cuff lesions at the last follow-up. Clinical and radiological outcomes were compared between groups divided according to the presence and types of subacromial erosions. Results Subacromial erosion was observed in 60% of patients (18/30): 13, 2, and 3 simple groove, cave, and marginal protrusion types, respectively. Four patients showed reduction loss at the final follow-up. There were no significant differences in clinical and radiological outcomes between the groups with and without subacromial erosion. Moreover, there were no significant differences between groups according to the types of subacromial erosion. There were no rotator cuff lesions, such as partial tears, in the injured shoulders. Conclusions Hook plate fixation may induce subacromial erosions. However, the subacromial erosions caused by the hook plate did not affect the clinical outcomes of type 5 AC joint dislocations. Moreover, regardless of its shape, the subacromial erosion did not affect the clinical outcomes nor cause rotator cuff lesions after plate removal.

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

2018 ◽  
Vol 21 (2) ◽  
pp. 95-100
Author(s):  
Joo Han Oh ◽  
Seunggi Min ◽  
Jae Wook Jung ◽  
Hee June Kim ◽  
Jae Yoon Kim ◽  
...  
Keyword(s):  
Plate Fixation ◽  
Clavicle Fracture ◽  
Hook Plate ◽  
Distal Clavicle ◽  
Ac Joint ◽  
Joint Dislocation ◽  
Group I ◽  
Joint Dislocations ◽  
Ac Joint Dislocation ◽  
Group Ii

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.

scholarly journals Comparative Outcome of Loop Suspensory Reconstruction and Hook Plate Fixation for Acute Type III-V Acromioclavicular Joint Dislocation

2020 ◽  
Author(s):  
Yu-Jui Chang ◽  
Wen-Yi Chou ◽  
Jih-Yang Ko ◽  
Hao-Chen Liu ◽  
Ya-Ju Yang ◽  
...  
Keyword(s):  
Plate Fixation ◽  
Hook Plate ◽  
Ac Joint ◽  
Joint Dislocation ◽  
Constant Murley Score ◽  
Group I ◽  
Ac Joint Dislocation ◽  
Group Ii ◽  
Reconstruction Group

Abstract Background Treatment options of acromioclavicular (AC) joint dislocation depend on the injury severity and the functional demand of the patient. Common surgical options include fixation across the AC joint, coracoclavicular (CC) fixation, and AC joint or CC reconstruction. However, the clinical superiority of these various procedures is controversial. This study aimed to compare the clinical and radiological outcomes of loop suspensory reconstruction and hook plate fixation for acute unstable AC joint dislocation.Methods We retrospectively included patients with acute unstable AC joint dislocation who were treated with loop suspensory reconstruction (group I, 23 cases) or hook plate fixation (group II, 14 cases) in our hospital from January 2010 to December 2016 with a minimum follow-up period of 1 year after surgery. We assessed the clinical outcomes of blood loss during surgery, surgical duration, duration of medication required for pain relief after the primary operation, occurrence of complications, and the Constant-Murley score; radiological analysis included postoperative arthritic change and the CC distance discrepancy ratio (CCDR) on preoperative and final follow-up plain films.Results The average follow-up duration was17.0±6.1 months. The mean duration of pain-control medication usage was 121.7±174.1 and 235.4±251.8 days in groups I and II, respectively, significantly lower in the CC reconstruction group (p=0.031). Group I revealed a superior Constant-Murley score at the final outpatient follow-up as compared with group II (71.7±15.8 vs 61.1±6.7, p=0.009). Regarding radiographic analysis, the hook plate group had a superior residual CCDR (group I vs II = 30% vs 80±40%, p<0.001). In addition, there were 9 cases of subluxation noted in group I and 2 cases in group II; however, 4 cases of acromion osteolysis were observed in group II.Conclusions The principle finding of the present study was that hook plate fixation was superior to loop suspensory reconstruction in terms of CC distance maintenance. However, the loop suspensory reconstruction group demonstrated superior clinical functional outcomes and less painkiller usage. A further randomized controlled trial with a long-term follow-up period is required.

scholarly journals Comparison of the TightRope system versus hook plate in acute acromioclavicular joint dislocations: a retrospective analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Guangsi Shen ◽  
Shengxuan Sun ◽  
Chengyang Tang ◽  
Ye Xie ◽  
Liubing Li ◽  
...  
Keyword(s):  
Los Angeles ◽  
Clinical Outcomes ◽  
Vertical Displacement ◽  
Hook Plate ◽  
Tunnel Widening ◽  
Joint Dislocations ◽  
Ac Joint Dislocation ◽  
Long Term Follow Up ◽  
Shoulder Score

AbstractThis study compared the results of the minimally invasive coracoclavicular (CC) fixation with a single TightRope (MITR) procedure and the hook plate (HP) procedure for acute acromioclavicular (AC) joint dislocation treatment. Sixteen patients with a mean age of 44.9 ± 11 years were treated with the MITR procedure. Nineteen patients with a mean age of 40.2 ± 8.7 years were treated using the HP procedure. Clinical outcomes were evaluated with the Visual Analog Scale (VAS) for pain, Constant–Murley Score (CMS), and University of California at Los Angeles (UCLA) Shoulder score. Vertical displacement of the clavicle with reference to the height of the acromion was measured in standard anteroposterior radiographs. The mean follow-up was 27 months in the MITR group and 30 months in the HP group. No statistically significant differences were found between the MITR group and the HR group in terms of VAS score (0.4 ± 0.6 vs 0.7 ± 0.6, P = 0.138), UCLA Shoulder score (33.9 ± 2.5 vs 33.7 ± 1.5, P = 0.843), or CMS (95.7 ± 7.3 vs 93.7 ± 6.6, P = 0.400). No redislocation was identified in the HP group, while redislocation occurred in 1 of 16 (6.3%) patients in the MITR group. One patient in the HP group (5.3%) had acromial osteolysis, while no acromial osteolysis was found in the MITR group. No other adverse events, such as infections, tunnel widening, fractures, or implant-related complications, were observed. Both procedures provided satisfactory results. The HP procedure provided better reduction, while the MITR procedure provided a slightly lower tendency of pain. Long-term follow-up is needed to investigate the clinical outcomes and radiological outcomes of both groups.

scholarly journals Comparison of clinical efficacy between arthroscopically assisted Tight-Rope technique and clavicular hook plate fixation in treating acute high-grade acromioclavicular joint separations

2021 ◽  
Vol 29 (2) ◽  
pp. 230949902110105
Author(s):  
Si Nie ◽  
Min Lan
Keyword(s):  
Constant Score ◽  
Plate Fixation ◽  
Hook Plate ◽  
High Grade ◽  
Ac Joint ◽  
Clavicular Hook Plate ◽  
Tight Rope ◽  
Arthroscopically Assisted ◽  
Rope System

Introduction: The purpose of this study was to compare the results of arthroscopically assisted reduction of acute acromioclavicular (AC) joint separations with the Tight-Rope technique with results of clavicular hook plate fixation. Materials and Methods: The 28 patients with acute high-grade AC joint dislocation were treated with arthroscopic assisted fixation using the Tight-Rope system, the arthroscopic evaluation and treatment of glenohumeral lesions were performed before AC ligament reconstruction. Each Tight-Rope technique group patient was matched with three controls that underwent clavicular hook plate fixation, and preoperation and postoperative visual analogue scale (VAS) and functional recovery (Constant Score) of the shoulder joint was assessed,. Furthermore, the demographics and clinical characteristics were compared between the two groups. Results: All patients had clinical and radiological results available at 2 years or greater (mean: 34; range: 24–72 months), they were statistically significant improvement in the constant score and VAS score at the end of follow-up respectively ( P < 0.001). Compared with the clavicular hook plate group, Tight-Rope system group patients were incurred significant statistically lower skin incision, hospitalization time and estimated blood loss ( P < 0.001), and the constant score and VAS score at the end of follow-up was significantly higher in the Tight-Rope group ( P < 0.001). Patients who underwent clavicular hook plate had a higher incidence of fixation failure [10 cases (11.9%) versus 2 cases (7.1%)] than those of the Tight-Rope system group. Conclusions: The Tight-Rope technique is advantageous for treating these patients because it is a minimally invasive procedure with low complications and superior clinical outcomes.

scholarly journals Clinical outcomes of hook-plate fixation in the treatment of unstable distal clavicular fractures and acromioclavicular joint dislocations

2015 ◽  
Vol 3 (1) ◽  
pp. 50
Author(s):  
NaifM Alhamam ◽  
IsamH Bella ◽  
FaresZ Uddin ◽  
MunirahA Al-Afaleq ◽  
SarahA Al-Afaleq ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Acromioclavicular Joint ◽  
Plate Fixation ◽  
Hook Plate ◽  
Joint Dislocations

scholarly journals Comparison between hook plate fixation with and without coracoclavicular ligament suture for acute acromioclavicular joint dislocations

2020 ◽  
Vol 28 (1) ◽  
pp. 230949902090505
Author(s):  
Joong-Bae Seo ◽  
Seong-Jun Kim ◽  
Hee-Jung Ham ◽  
Jae-Sung Yoo
Keyword(s):  
Clinical Outcomes ◽  
Acromioclavicular Joint ◽  
Plate Fixation ◽  
Implant Removal ◽  
Hook Plate ◽  
Ligament Repair ◽  
Significant Difference ◽  
Patient Groups ◽  
Repair Group

Background: Hook plates are widely used for repair of acromioclavicular joint (ACJ) dislocations. However, it is unclear whether repair of torn coracoclavicular (CC) ligament is necessary. The purpose of this study was to evaluate the outcomes of the hook plate fixation with direct CC ligament repair for acute ACJ dislocation in comparison with the hook plate fixation without direct CC ligament repair. Methods: The study included 120 patients with acute ACJ dislocations who underwent surgery. The patients were divided into 73 patient groups with Arbeitsgemeinschaft für Osteosynthesefragen (AO) hook plate fixation and direct CC ligament repair and 47 patient groups without direct CC ligament repair. For clinical assessments, the American Shoulder and Elbow Surgeons score, constant score, and time for implant removal were recorded. The corcoclavicular distance (CCD) and the CCD ratio were used for the evaluation of reduction. Typical reported complications, such as secondary dislocation, implant failure or loosening, peri-implant fracture, acromion osteolysis, and postoperative ACJ arthrosis, were also analyzed. Results: There were no differences in the clinical outcomes between the two groups. There was no difference in the timing of implant removal between the two groups. The last follow-up CCD was not statistically significant between group with direct CC ligament repair and without repair (9.1 ± 3.3 vs. 9.0 ± 2.8, respectively, p > 0.05). The last follow-up CCD ratio showed significant differences between the two groups (12.6 ± 25.5% vs. 26.3 ± 39.7, respectively, p < 0.05). There was no statistically significant difference in the complication rate between the two groups. Conclusion: The hook plate fixation with direct CC ligament repair group was better for maintenance of reduction than that of the hook plate fixation without direct CC ligament repair group. Although, there were no differences of clinical outcomes and complications between two groups. Level of Evidence: Level III, Retrospective Study.

Comparative study of arthroscopically assisted Tight-Rope technique and clavicular hook plate fixation treatment in acute high grade acromioclavicular joint separations

2020 ◽  
Author(s):  
Hong-bo Li ◽  
Si Nie ◽  
Zhi-ming Tang ◽  
Xin-gen Liao ◽  
Min Lan
Keyword(s):  
Constant Score ◽  
Plate Fixation ◽  
Hook Plate ◽  
High Grade ◽  
Ac Joint ◽  
Clavicular Hook Plate ◽  
Tight Rope ◽  
Arthroscopically Assisted ◽  
Rope System

Abstract Background: Has the arthroscopically assisted reduction of acute acromioclavicular (AC) joint separations with the tight-rope technique advantages over the clavicular hook plate fixation.Methods: A total of 518 patients with acute high grade AC joint dislocation received ligament reconstruction surgery between February 2015 and June 2017 were included in this study. Of these patients, 28 patients were treated with arthroscopic assisted fixation using Tight-Rope system. In order to compare the treatment results between Tight-Rope technique and clavicular hook plate fixation, each Tight-Rope technique group patients was matched with 3 controls that underwent clavicular hook plate fixation at the same period according to gender, age and diagnosis. Furthermore, the demographics and clinical characteristics were compared between the two groups.Results: All patients had clinical and radiological results available at 2 year or greater, they was statistically significant improvement in the constant score and VAS score at the end of follow up respectively (P < 0.001). Compared with clavicular hook plate group, patients treated with arthroscopic assisted fixation using Tight-Rope system were incurred significant statistically lower skin incision, hospitalization time and estimated blood loss (p <0.001), and the constant score and VAS score at the end of follow up was significant higher in Tight-Rope group (p <0.001).Conclusions: The Tight-Rope technique is advantageous for treating these patients because it is minimally invasive procedure with low complications and superior clinical outcomes.Authors’ Contribution:The first and second author (Hong-bo Li and Si Nie) contributed equally to this study and share the first authorship.

scholarly journals Clinical outcomes after mini-hook plate fixation for small avulsion fractures around the interphalangeal or metacarpophalangeal joints of the hand

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Jung Il Lee ◽  
Ki-Chul Park ◽  
Hyun Soo So ◽  
Duk Hee Lee
Keyword(s):  
Clinical Outcomes ◽  
Plate Fixation ◽  
Hook Plate ◽  
Joint Stability ◽  
Avulsion Fractures ◽  
Metacarpophalangeal Joints ◽  
Early Results ◽  
Mallet Fracture ◽  
Osseous Union ◽  
Central Slip

Abstract Background Mini-hook plate has been described for the treatment of various small avulsion fragments in the hand. This retrospective study aimed to evaluate clinical outcomes after mini-hook plate fixation in patients with an avulsion fracture around the interphalangeal or metacarpophalangeal joints of the hand. Methods Nineteen patients with avulsion fractures around the interphalangeal or metacarpophalangeal joints of the hand were included in this study. Seven patients had a mallet fracture, and 12 patients had other phalangeal avulsion fractures including central slip, collateral ligament, volar plate, and flexor avulsion fractures. The osseous union and functional outcomes, including finger joint motion, joint stability, pinching strength, and the disabilities of the arm, shoulder, and hand score, were evaluated. Results The mean duration of follow-up was 33.8 months. All patients in mallet and other phalangeal avulsion fractures achieved osseous union between the avulsion fragment and phalangeal bone, and there was no joint subluxation. There were no significant differences in the disabilities of the arm, shoulder, and hand scores. However, the patients with mallet fracture have lower mean percentage values of the total active range of motion and pinching strength than other phalangeal avulsion fractures. We abandoned this procedure in mallet fractures because the early results after mini-hook plate fixation in mallet fractures appeared unfavorable. Conclusion These results suggest that the mini-hook plate fixation can provide sufficient stability and good clinical outcomes in those with phalangeal avulsion fractures. However, the outcomes for mallet fractures were not as good as those for other phalangeal avulsion fractures.

scholarly journals Calcifying tendinitis of the shoulder: arthroscopic needling versus complete calcium removal and rotator cuff repair. A prospective comparative study

Joints ◽  
2015 ◽  
Vol 03 (04) ◽  
pp. 166-172 ◽  
Author(s):  
Alessandro Castagna ◽  
Silvana De Giorgi ◽  
Raffaele Garofalo ◽  
Marco Conti ◽  
Silvio Tafuri ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Comparative Study ◽  
Clinical Outcomes ◽  
Tendon Repair ◽  
Complete Removal ◽  
Calcium Deposit ◽  
Calcifying Tendinitis ◽  
Clinical Scores ◽  
Prospective Comparative Study

Purpose: the aim of the present study was to verify the differences in the clinical outcomes of two arthroscopic techniques used to treat calcifying tendinitis of the shoulder: needling versus complete removal of the calcium deposit and tendon repair. Methods: from September 2010 to September 2012, 40 patients with calcifying tendinitis of the rotator cuff were arthroscopically treated by the same surgeon using one of the two following techniques: needling (Group 1) and complete removal of the calcium deposit and tendon repair with suture anchors (Group 2). Both groups followed the same rehabilitation program. The two groups were compared at 6 and 12 months of follow-up for the presence of residual calcifications and for the following clinical outcomes: Constant score, American Shoulder and Elbow Surgeons Evaluation Form (ASES) shoulder score, University of California Los Angeles (UCLA) shoulder rating scale, Simple Shoulder Test (SST) and Visual Analogue Scale (VAS). Results: all the clinical scores (Constant, ASES, UCLA, SST and VAS scores) improved significantly between baseline and postoperative follow-up, both at 6 and at 12 months. no differences at final follow-up were found between the two groups. Conclusions: both the techniques were effective in solving the symptoms of calcifying tendinitis of the shoulder. Clinical scores improved in both groups. Residual calcifications were found in only a few cases and were always less than 10 mm. Level of evidence:Level II, prospective comparative study.

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