Is coracoclavicular reconstruction necessary in hook plate fixation for acute unstable acromioclavicular dislocation?

Abstract Background Acromioclavicular joint (ACJ) dislocation is a relatively common shoulder injury. For the treatment of cases of severe ACJ dislocation (Rockwood type III–V), hook plate fixation is an easy-to-master and minimally-invasive approach to surgical intervention. Overstress on the acromion following hook plate fixation often leads to acromial complications such as osteolysis and loss of reduction. We hypothesized that suspensory reconstruction alongside hook plate fixation might provide a superior stability and reduce complications as compared with hook plate fixation alone. The purpose of the study was to assess the clinical and radiographic outcomes of these two surgical modalities. Methods We retrospectively enrolled 38 patients with acute ACJ dislocation from May 2010 to December 2018. Among them, nineteen patients received hook plate fixation only (HP group), and 19 underwent concomitant hook plate fixation and loop suspension fixation with two mersilene sutures (HM group). The demographic data of the patients were recorded and analyzed. All patients underwent a shoulder x-ray initially, immediately postoperatively, and at 1, 3, 6 and 12 months to measure the relative coracoclavicular distance (rCCD). Clinical assessment of shoulder function outcome was conducted using the Constant Murley Score (CMS); the University of California at Los Angeles (UCLA) Shoulder Score was also measured at the latest follow-up. Results There were no significant differences in the demographic data between the two groups. With regards to the CMS and the UCLA score, the HM group and HP group both had excellent outcomes, and no significant differences in scores were observed between groups (CMS: 93.90 ± 6.16 versus 94.47 ± 7.26, p = 0.47; UCLA score: 32.84 ± 2.91 versus 34.32 ± 1.16, p = 0.07). However, the HM group demonstrated substantial superiority in terms of maintenance of the rCCD over the HP group (91.47 ± 27.47 versus 100.75 ± 48.70, p = 0.015). In addition, there was less subacromial osteolysis in the HM group than the HP group (52.6% versus 15.8%, p = 0.038). Conclusion Concomitant hook plate fixation with loop suspensory reconstruction yielded excellent functional outcomes and superior maintenance of the rCCD with fewer acromion complications than hook plate fixation alone.

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Is coracoclavicular reconstruction necessary in hook plate fixation for acute unstable acromioclavicular dislocation?

10.21203/rs.3.rs-50026/v3 ◽

2020 ◽

Author(s):

Yu-Ta Chen ◽

Kuan-Ting Wu ◽

Shun-Wun Jhan ◽

Shan-Ling Hsu ◽

Hao-Chen Liu ◽

...

Keyword(s):

Los Angeles ◽

Plate Fixation ◽

Demographic Data ◽

Shoulder Function ◽

Hook Plate ◽

Shoulder Injury ◽

Invasive Approach ◽

Radiographic Outcomes ◽

Ucla Score ◽

Rockwood Type Iii

Abstract Background: Acromioclavicular joint (ACJ) dislocation is a relatively common shoulder injury. For the treatment of cases of severe ACJ dislocation (Rockwood type III–V), hook plate fixation is a neasy-to-master and minimally-invasive approach to surgical intervention. Over stress on the acromion following hook plate fixation often leads to acromial complications such as osteolysis and loss of reduction. We hypothesized that suspensory reconstruction a longside hook plate fixation might provide a superior stability and reduce complications as compared with hook plate fixation alone. The purpose of the study was to assess the clinical and radiographic outcomes of these two surgical modalities.Methods: We retrospectively enrolled 49 patients with acute ACJ dislocation from May 2010 to December 2018. Among them, nineteen patients received hook plate fixation only (HP group), and 19 underwent concomitant hook plate fixation and loop suspension fixation with two mersilene sutures (HM group). The demographic data of the patients were recorded and analyzed. All patients underwent a shoulder x-ray initially, immediately postoperatively, and at 1, 3, 6 and12 months to measure the relative coracoclavicular distance (rCCD). Clinical assessment of shoulder function outcome was conducted using the Constant Murley Score (CMS); the University of California at Los Angeles (UCLA) Shoulder Score was also measured at the latest follow-up.Results: There were no significant differences in the demographic data between the two groups. With regards to the CMS and the UCLA score, the HM group and HP group both had excellent outcomes, and no significant differences in scores were observed between groups (CMS: 93.90±6.16 versus 94.47±7.26, p=0.47; UCLA score: 32.84±2.91 versus 34.32±1.16, p=0.07). However, the HM group demonstrated substantial superiority in terms of maintenance of the rCCD over the HP group (91.47±27.47 versus 100.75±48.70, p=0.015). In addition, there was less subacromial osteolysis in the HM group than the HP group (52.6% versus 15.8%, p=0.038).Conclusion: Both fixations yielded excellent functional outcomes. However, concomitant hook plate fixation with loop suspensory reconstruction demonstrated the fewer acromion complications and statistical differences in reduction maintenance with less clinical significance.

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Is coracoclavicular reconstruction necessary in hook plate fixation for acute unstable acromioclavicular dislocation?

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-03978-3 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Yu-Ta Chen ◽

Kuan-Ting Wu ◽

Shun-Wun Jhan ◽

Shan-Ling Hsu ◽

Hao-Chen Liu ◽

...

Keyword(s):

Los Angeles ◽

Plate Fixation ◽

Demographic Data ◽

Shoulder Function ◽

Hook Plate ◽

Shoulder Injury ◽

Invasive Approach ◽

Radiographic Outcomes ◽

Ucla Score ◽

Rockwood Type Iii

Abstract Background Acromioclavicular joint (ACJ) dislocation is a relatively common shoulder injury. For the treatment of cases of severe ACJ dislocation (Rockwood type III–V), hook plate fixation is an easy-to-master and minimally-invasive approach to surgical intervention. Over stress on the acromion following hook plate fixation often leads to acromial complications such as osteolysis and loss of reduction. We hypothesized that suspensory reconstruction alongside hook plate fixation might provide a superior stability and reduce complications as compared with hook plate fixation alone. The purpose of the study was to assess the clinical and radiographic outcomes of these two surgical modalities. Methods We retrospectively enrolled 49 patients with acute ACJ dislocation from May 2010 to December 2018. Among them, 19 patients received hook plate fixation only (HP group), and 19 underwent concomitant hook plate fixation and loop suspension fixation with two mersilene sutures (HM group). The demographic data of the patients were recorded and analyzed. All patients underwent a shoulder X-ray initially, immediately postoperatively, and at 1, 3, 6 and 12 months to measure the relative coracoclavicular distance (rCCD). Clinical assessment of shoulder function outcome was conducted using the Constant Murley Score (CMS); the University of California at Los Angeles (UCLA) Shoulder Score was also measured at the latest follow-up. Results There were no significant differences in the demographic data between the two groups. With regards to the CMS and the UCLA score, the HM group and HP group both had excellent outcomes, and no significant differences in scores were observed between groups (CMS: 93.90 ± 6.16 versus 94.47 ± 7.26, p = 0.47; UCLA score: 32.84 ± 2.91 versus 34.32 ± 1.16, p = 0.07). However, the HM group demonstrated substantial superiority in terms of maintenance of the rCCD over the HP group (91.47 ± 27.47 versus 100.75 ± 48.70, p = 0.015). In addition, there was less subacromial osteolysis in the HM group than the HP group (52.6% versus 15.8%, p = 0.038). Conclusion Both fixations yielded excellent functional outcomes. However, concomitant hook plate fixation with loop suspensory reconstruction demonstrated the fewer acromion complications and statistical differences in reduction maintenance with less clinical significance.

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Is coracoclavicular reconstruction necessary in hook plate fixation for acute unstable acromioclavicular dislocation?

10.21203/rs.3.rs-50026/v4 ◽

2021 ◽

Author(s):

Yu-Ta Chen ◽

Kuan-Ting Wu ◽

Shun-Wun Jhan ◽

Shan-Ling Hsu ◽

Hao-Chen Liu ◽

...

Keyword(s):

Los Angeles ◽

Plate Fixation ◽

Demographic Data ◽

Shoulder Function ◽

Hook Plate ◽

Shoulder Injury ◽

Invasive Approach ◽

Radiographic Outcomes ◽

Ucla Score ◽

Rockwood Type Iii

Abstract Background:Acromioclavicular joint (ACJ) dislocation is a relatively common shoulder injury. For the treatment of cases of severe ACJ dislocation (Rockwood type III–V), hook plate fixation is a neasy-to-master and minimally-invasive approach to surgical intervention. Over stress on the acromion following hook plate fixation often leads to acromial complications such as osteolysis and loss of reduction. We hypothesized that suspensory reconstruction a longside hook plate fixation might provide a superior stability and reduce complications as compared with hook plate fixation alone. The purpose of the study was to assess the clinical and radiographic outcomes of these two surgical modalities.Methods: We retrospectively enrolled 49 patients with acute ACJ dislocation from May 2010 to December 2018. Among them, nineteen patients received hook plate fixation only (HP group), and 19 underwent concomitant hook plate fixation and loop suspension fixation with two mersilene sutures (HM group). The demographic data of the patients were recorded and analyzed. All patients underwent a shoulder x-ray initially, immediately postoperatively, and at 1, 3, 6 and12 months to measure the relative coracoclavicular distance (rCCD). Clinical assessment of shoulder function outcome was conducted using the Constant Murley Score (CMS); the University of California at Los Angeles (UCLA) Shoulder Score was also measured at the latest follow-up.Results: There were no significant differences in the demographic data between the two groups. With regards to the CMS and the UCLA score, the HM group and HP group both had excellent outcomes, and no significant differences in scores were observed between groups (CMS: 93.90±6.16 versus 94.47±7.26, p=0.47; UCLA score: 32.84±2.91 versus 34.32±1.16, p=0.07). However, the HM group demonstrated substantial superiority in terms of maintenance of the rCCD over the HP group (91.47±27.47 versus 100.75±48.70, p=0.015). In addition, there was less subacromial osteolysis in the HM group than the HP group (52.6% versus 15.8%, p=0.038).Conclusion: Both fixations yielded excellent functional outcomes. However, concomitant hook plate fixation with loop suspensory reconstruction demonstrated the fewer acromion complications and statistical differences in reduction maintenance with less clinical significance.

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Is Coracoclavicular Reconstruction Necessary in Hook Plate Fixation for Acute Unstable Acromioclavicular Dislocation?

10.21203/rs.3.rs-50026/v1 ◽

2020 ◽

Author(s):

Yu-Ta Chen ◽

Kuan-Ting Wu ◽

Shun-Wun Jhan ◽

Shan-Lin Hsu ◽

Hao-Chen Liu ◽

...

Keyword(s):

Los Angeles ◽

Plate Fixation ◽

Demographic Data ◽

Shoulder Function ◽

Hook Plate ◽

Shoulder Injury ◽

Invasive Approach ◽

Radiographic Outcomes ◽

Ucla Score ◽

Rockwood Type Iii

Abstract Background: Acromioclavicular joint (ACJ) dislocation is a relatively common shoulder injury. For the treatment of cases of severe ACJ dislocation (Rockwood type III–V), hook plate fixation is an easy-to-master and minimally-invasive approach to surgical intervention. Overstress on the acromion following hook plate fixation often leads to acromial complications such as osteolysis and loss of reduction. We hypothesized that suspensory reconstruction alongside hook plate fixation might provide a superior stability and reduce complications as compared with hook plate fixation alone. The purpose of the study was to assess the clinical and radiographic outcomes of these two surgical modalities.Methods: We retrospectively enrolled 38 patients with acute ACJ dislocation from May 2010 to December 2018. Among them, nineteen patients received hook plate fixation only (HP group), and 19 underwent concomitant hook plate fixation and loop suspension fixation with two mersilene tapes (HM group). The demographic data of the patients were recorded and analyzed. All patients underwent a shoulder x-ray initially, immediately postoperatively, and at 1, 3, 6 and 12 months to measure the relative coracoclavicular distance (rCCD). Clinical assessment of shoulder function outcome was conducted using the Constant Murley Score (CMS); the University of California at Los Angeles (UCLA) Shoulder Score was also measured at the latest follow-up.Results: There were no significant differences in the demographic data between the two groups. With regards to the CMS and the UCLA score, the HM group and HP group both had excellent outcomes, and no significant differences in scores were observed between groups (CMS: 93.90 ± 6.16 versus 94.47 ± 7.26, p = 0.47; UCLA score: 32.84 ± 2.91 versus 34.32 ± 1.16, p = 0.07). However, the HM group demonstrated substantial superiority in terms of maintenance of the rCCD over the HP group (91.47 ± 27.47 versus 100.75 ± 48.70, p = 0.015). In addition, there was less subacromial osteolysis in the HM group than the HP group (52.6% versus 15.8%, p = 0.038).Conclusion: Concomitant hook plate fixation with loop suspensory reconstruction yielded excellent functional outcomes and superior maintenance of the rCCD with fewer acromion complications than hook plate fixation alone.

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Is Coracoclavicular Reconstruction Necessary in Hook Plate Fixation for Acute Unstable Acromioclavicular Dislocation?

10.21203/rs.3.rs-34366/v1 ◽

2020 ◽

Author(s):

Yu-Ta Chen ◽

Kuan-Ting Wu ◽

Shun-Wun Jhan ◽

Shan-Lin Hsu ◽

Hao-Chen Liu ◽

...

Keyword(s):

Los Angeles ◽

Plate Fixation ◽

Demographic Data ◽

Shoulder Function ◽

Hook Plate ◽

Shoulder Injury ◽

Invasive Approach ◽

Radiographic Outcomes ◽

Ucla Score ◽

Rockwood Type Iii

Abstract Background: Acromioclavicular joint (ACJ) dislocation is a relatively common shoulder injury. For the treatment of cases of severe ACJ dislocation (Rockwood type III–V), hook plate fixation is an easy-to-master and minimally-invasive approach to surgical intervention. Overstress on the acromion following hook plate fixation often leads to acromial complications such as osteolysis and loss of reduction. We hypothesized that suspensory reconstruction alongside hook plate fixation might provide a superior stability and reduce complications as compared with hook plate fixation alone. The purpose of the study was to assess the clinical and radiographic outcomes of these two surgical modalities.Methods: We retrospectively enrolled 38 patients with acute ACJ dislocation from May 2010 to December 2018. Among them, nineteen patients received hook plate fixation only (HP group), and 19 underwent concomitant hook plate fixation and loop suspension fixation with two mersilene tapes (HM group). The demographic data of the patients were recorded and analyzed. All patients underwent a shoulder x-ray initially, immediately postoperatively, and at 1, 3, 6 and 12 months to measure the relative coracoclavicular distance (rCCD). Clinical assessment of shoulder function outcome was conducted using the Constant Murley Score (CMS); the University of California at Los Angeles (UCLA) Shoulder Score was also measured at the latest follow-up.Results: There were no significant differences in the demographic data between the two groups. With regards to the CMS and the UCLA score, the HM group and HP group both had excellent outcomes, and no significant differences in scores were observed between groups (CMS: 93.90 ± 6.16 versus 94.47 ± 7.26, p = 0.47; UCLA score: 32.84 ± 2.91 versus 34.32 ± 1.16, p = 0.07). However, the HM group demonstrated substantial superiority in terms of maintenance of the rCCD over the HP group (91.47 ± 27.47 versus 100.75 ± 48.70, p = 0.015). In addition, there was less subacromial osteolysis in the HM group than the HP group (52.6% versus 15.8%, p = 0.038).Conclusion: Concomitant hook plate fixation with loop suspensory reconstruction yielded excellent functional outcomes and superior maintenance of the rCCD with fewer acromion complications than hook plate fixation alone.

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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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Locking or Non-locking Hook Plate in Treatment of Unstable Lateral Clavicle Fracture

ARS Medica Tomitana ◽

10.2478/arsm-2014-0027 ◽

2015 ◽

Vol 20 (3) ◽

pp. 150-152

Author(s):

Şerban Al. O. ◽

Obadâ B.

Keyword(s):

Medical Records ◽

Demographic Data ◽

Clavicle Fracture ◽

Shoulder Function ◽

Hook Plate ◽

Lateral Clavicle Fracture ◽

Lateral Clavicle ◽

Clavicular Hook Plate ◽

Clavicle Fractures

Abstract The purpose of this study was to compare the outcomes and complications of locking or nonlocking clavicular hook plate for fixation of unstable lateral clavicle fractures. All patients with unstable Neer type II lateral clavicle fractures were operated in our hospital from January 2011 to December 2012. The included participants received either locking or nonlocking clavicular hook plate operations. Demographic data, medical records and radiographs were reviewed retrospectively. At the last follow-up, shoulder function was evaluated with Constant-Murley scoring system. Our findings suggest that locking clavicular hook plates are equally useful for treating unstable lateral clavicular fractures, but in face of complicated ones, the locking hook plate would not get more benefits than nonlocking hook plate.

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The Clinical Results of Arthroscopic Treatment for Calcified Tendinitis of Rotator Cuff—— A Retrospective Study With No Less Than 2 Years Follow Up

10.21203/rs.3.rs-84459/v1 ◽

2020 ◽

Author(s):

Tao Li ◽

Yan Xiong ◽

WanYi Qing ◽

Jian Li ◽

Xin Tang

Keyword(s):

Los Angeles ◽

Rotator Cuff ◽

Arthroscopic Surgery ◽

Clinical Results ◽

Vas Score ◽

Radiographic Outcomes ◽

Randomized Controlled Studies ◽

Arthroscopic Excision ◽

Ucla Score

Abstract Background The treatment of CT remains controversial. The aim of this study was to retrospectively evaluate the pain and functional outcomes of arthroscopic excision with or without rotator cuff repair for treating calcified tendinitis of the rotator cuff.Methods Between Jan 2015 and Apr 2018, a total of 38 patients with 39 shoulders CT of the rotator cuff underwent arthroscopic surgery and were followed for at least two years. The clinical outcomes were evaluated at intervals of 2, 4, and 8 weeks and 3, 6，12 and 24 months after the surgery and annually thereafter. The efficacy measures included the visual analogue scale (VAS) score, University of California at Los Angeles (UCLA) score, American Shoulder and Elbow Surgeons (ASES) score and radiographic outcomes.Results All patients underwent follow-ups, and the mean follow-up time was 45.38 months. The VAS score significantly decreased from 73.59±11.35 mm before the surgery to 26.41±10.63 mm at 6 months after surgery and continued to decrease to 5.64±5.02 mm at the end of the follow-up period (all p < 0.01). This result was supported by a significant increase in both the UCLA score and ASES score (all p<0.01) after surgery. Plain radiographs after surgery revealed complete calcification removal in all patients. No recurrence was observed during the follow-up period.Conclusions Arthroscopic excision can relieve pain and improve shoulder joint function in patients with CT. Additional randomized controlled studies need to be conducted to confirm our findings.

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Outcome of Acromio-Clavicular joint dislocation operated using clavicle hook plate

Journal of Chitwan Medical College ◽

10.3126/jcmc.v8i2.23737 ◽

2018 ◽

Vol 8 (2) ◽

pp. 41-43

Author(s):

Akesh Prajapati ◽

Jyoti Sitaula ◽

Bishnu Dev Sharma ◽

Sujit Shrestha ◽

Pujan Pant ◽

...

Keyword(s):

Los Angeles ◽

Excellent Result ◽

Hook Plate ◽

Acromioclavicular Joint Dislocation ◽

Ac Joint ◽

Rockwood Classification ◽

Joint Dislocation ◽

Joint Dislocations ◽

Rockwood Type Iii ◽

Clavicle Hook Plate

Rockwood classification of AC joint dislocation is generally accepted worldwide. Treatment of Rockwood Type 1 and 2 AC joint is non-operative while all authors advocate operative treatment for Rockwood Type 4 and 5 AC joint dislocations. Thirty consecutive patients who underwent operation for acromioclavicular joint dislocation using clavicle hook plate from June 2015 were studied. The dislocations ranged from Rockwood type III to type V. Average follow up time was fourteen months ranging from four to twenty-four months. The outcome was measured using University of California Los Angeles (UCLA) shoulder score. All-the patient had good to excellent result.

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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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