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

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.

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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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Hook Plate Fixation of Medial Malleolar Fractures: A Comparative Study of Clinical Outcomes

The Journal of Foot & Ankle Surgery ◽

10.1053/j.jfas.2018.12.048 ◽

2020 ◽

Vol 59 (5) ◽

pp. 969-971

Author(s):

Sravya P. Vajapey ◽

Ryan K. Harrison

Keyword(s):

Comparative Study ◽

Clinical Outcomes ◽

Plate Fixation ◽

Hook Plate ◽

Malleolar Fractures

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Technical Note: Hook plate fixation of FDP avulsion fractures

The Internet Journal of Hand Surgery ◽

10.5580/453 ◽

2007 ◽

Vol 1 (2) ◽

Keyword(s):

Plate Fixation ◽

Technical Note ◽

Hook Plate ◽

Avulsion Fractures

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

Saudi Journal of Medicine and Medical Sciences ◽

10.4103/1658-631x.149679 ◽

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

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Functional outcomes and complications of hook plate for bony mallet finger: a retrospective case series study

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04163-2 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Wei-Chih Wang ◽

Cheng-En Hsu ◽

Chen-Wei Yeh ◽

Tsung-Yu Ho ◽

Yung-Cheng Chiu

Keyword(s):

Functional Outcomes ◽

Plate Fixation ◽

Case Series ◽

Hook Plate ◽

Dash Score ◽

Mallet Finger ◽

Retrospective Case ◽

Nail Deformity ◽

Soft Tissue Dissection ◽

Mallet Fracture

Abstract Background The treatment of mallet fracture using hook plate fixation was first introduced in 2007 and has subsequently shown excellent outcomes. Common complications, such as nail deformity and screw loosening, have also been reported. Very few studies have focused on these common complications or their prevention. In this study, we present the clinical outcomes and complications of our case series and describe the pitfalls and detailed solution of surgical tips to avoid common complications related to this procedure. Methods The retrospective case series of 16 patients with mallet fractures who underwent open reduction and hook plate fixation in our hospital from 2015 to 2020 were retrospectively reviewed. Data on extension lag, range-of-motion (ROM) of the distal interphalangeal joint (DIP) joint, the Disabilities of the Arm, Shoulder, and Hand (DASH) score, and surgical complications were collected and analysed. The clinical outcome was graded according to the Crawford mallet finger criteria. Results Sixteen patients were included in our analysis. The median DIP extension lag was 0° (range, 0° to 30°) and the median active DIP flexion angle was 60° (range, 40° to 90°). The median DASH score was 0 (range, 0–11.3). Fourteen patients with good and excellent results were satisfied with this treatment. The Complication rate in our patient series was 18%. Common complications reported in articles included wound necrosis, extension lag, nail deformity, and plate loosening. Conclusions Despite the fact that the treatment of mallet fracture with hook plate fixation has satisfactory functional outcomes, pitfalls, including iatrogenic nail germinal matrix injury, unnecessary soft tissue dissection, and insufficient screw purchase, were still reported. To avoid complications, we suggest modifications of the skin incision, soft tissue dissection, and screw position.

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

Journal of Orthopaedic Surgery ◽

10.1177/2309499020905058 ◽

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.

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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

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04987-y ◽

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.

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Hook Plate Fixation for Isolated Greater Tuberosity Fractures of the Humerus

Clinics in Shoulder and Elbow ◽

10.5397/cise.2017.20.4.222 ◽

2017 ◽

Vol 20 (4) ◽

pp. 222-229

Author(s):

Kyoung Rak Lee ◽

Ki Cheor Bae ◽

Chang Jin Yon ◽

Chul Hyun Cho

Keyword(s):

Los Angeles ◽

Clinical Outcomes ◽

External Rotation ◽

Plate Fixation ◽

Treatment Method ◽

Hook Plate ◽

Greater Tuberosity ◽

Arthroscopic Capsular Release ◽

The Mean ◽

The University

BACKGROUND: The purpose of this study was to investigate the outcomes after fixation using a 3.5-mm locking compression plate (LCP) hook plate for isolated greater tuberosity (GT) fractures of the proximal humerus.METHODS: We evaluated the postoperative radiological and clinical outcomes in nine patients who were followed up at least 1 year with isolated GT fractures. Using the deltopectoral approach, we fixed the displaced GT fragments with a 3.5-mm LCP hook plate (Synthes, West Chester, PA, USA). Depending on the fracture patterns, the hook plate was fixed with or without augmentation using either tension suture or suture anchor fixation.RESULTS: All the patient showed successful bone union. The mean time-to-union was 11 weeks. The radiological and clinical outcomes at the final follow-up were generally satisfactory. The mean visual analogue scale for pain, the University of California at Los Angeles score, the American Shoulder and Elbow Surgeons score, and the subjective shoulder value were 1.4, 30.3, 84.3, and 82.2%, respectively. The mean active forward flexion, abduction, external rotation, and internal rotation of the shoulder were 156.7°, 152.2°, 61.1°, and the 10th thoracic vertebral level, respectively. Only one patient presented with a postoperative complication of shoulder stiffness. The patient was treated through arthroscopic capsular release on the 5th postoperative month.CONCLUSIONS: We conclude that fixation using 3.5-mm LCP hook plates for isolated GT fractures of the proximal humerus is a useful treatment method that provides satisfactory clinical and radiological outcomes.

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