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

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

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02339-z ◽

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.

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Arthroscopic-assisted hook plate fixation for acromioclavicular joint dislocation

International Orthopaedics ◽

10.1007/s00264-012-1691-6 ◽

2012 ◽

Vol 37 (1) ◽

pp. 77-82 ◽

Cited By ~ 11

Author(s):

Justus Gille ◽

Gerhard Heinrichs ◽

Andreas Unger ◽

Helge Riepenhof ◽

Jan Herzog ◽

...

Keyword(s):

Acromioclavicular Joint ◽

Plate Fixation ◽

Hook Plate ◽

Acromioclavicular Joint Dislocation ◽

Joint Dislocation

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

Clinics in Shoulder and Elbow ◽

10.5397/cise.2018.21.2.95 ◽

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.

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