Clinical outcomes of bending versus non-bending of the plate hook in acromioclavicular joint dislocation

Background: We aimed to assess the effect of plate hook bending in treatment of acromioclavicular (AC) dislocation by analyzing clinical and radiological results according to the angle of the plate hook (APH).Methods: This was a retrospective, observational, case-control study including 76 patients with acute AC joint dislocation that were divided into two groups according to treatment with bent or unbent plate hook. The visual analog scale (VAS), the American Shoulder and Elbow Surgeons (ASES) shoulder score, and range of motion (ROM) were evaluated as clinical outcomes. Comparative coracoclavicular distance (CCD) was measured to evaluate radiological outcomes.Results: While the VAS and ASES of the bending group at 4 months after surgery were significantly higher (P=0.021, P=0.019), the rest of those and ROM showed no significant difference. The initial CCD decreased from 183.2%±25.4% to 114.3%±18.9% at the final follow-up in the bending group and decreased from 188.2%±34.4% to 119.1%±16.7% in the non-bending group, with no statistical difference (P=0.613). The changes between the initial and post-metal removal CCD were 60.2%±11.2% and 57.3%±10.4%, respectively, with no statistical difference (P=0.241). The non-bending group showed greater subacromial osteolysis (odds ratio, 3.87). Pearson’s coefficients for the correlation between APH and VAS at 4 months after surgery and for that between APH and ASES at 4 months after surgery were 0.74 and –0.63 (P=0.027 and P=0.032), respectively.Conclusions: The APH was associated with improved postoperative pain and clinical outcomes before implant removal and with reduced complications; therefore, plate hook bending is more useful clinically during plate implantation.

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A retrospective comparative study of arthroscopic fixation for acute acromioclavicular joint dislocation: coracoid sling technique versus single-tunnel technique

10.21203/rs.3.rs-142875/v1 ◽

2021 ◽

Author(s):

Liangquan Peng ◽

Yizi Zheng ◽

Greg Zhang ◽

Zhenhan Deng

Keyword(s):

Clinical Outcomes ◽

Acromioclavicular Joint Dislocation ◽

Return To Sports ◽

Ac Joint ◽

Joint Dislocation ◽

Ac Joint Dislocation ◽

Significant Difference ◽

Tunnel Technique ◽

Arthroscopic Fixation

Abstract Background Arthroscopic fixation in acute acromioclavicular (AC) joint dislocation has become more popular and shown good clinical outcomes. This study aims to evaluate and compare the efficacy of single-tunnel technique (SST) and coracoid sling technique (CST) for the treatment of acute AC joint dislocation in order to provide more suitable treatment options and clinical recommendations for orthopaedic surgeons. Methods We retrospectively reviewed the charts of patients with acute Rockwood type IV and V AC joint dislocation who had undergone arthroscopic fixation procedure with SST or CST fixation between June 2009 and June 2018. A total of 90 consecutive patients identified from chart review were picked and divided into SST and CST groups, with 45 members in each group. The Visual Analog Scale (VAS) pain score, Constant shoulder functionality score, Karlsson AC joint score, the time of return to sports and activity, and plain radiographs of the affected shoulder at different time points of follow-up were all recorded for a minimum of 2 years postoperatively. Results The majority of the patients in both groups recovered to their preoperative activity levels with few complications. The average postoperative AC and coracoclavicular (CC) distances were significantly narrower than preoperative measurements in both groups, and no significant difference was observed between the two groups at 2 years post-op. The CST group had reduced operative time, shorter time of recovery of shoulder movements, higher Constant functionality scores and Karlsson AC joint scores, and fewer complications than the STT group at the last clinical follow-up. Conclusions CST technique achieved superior clinical outcomes with fewer complications compared to the traditional STT technique in arthroscopic treatment of acute AC joint dislocation. This technique could be considered as a reliable method for AC joint reconstruction.

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Fifteen-degree clavicular hook plate achieves better clinical outcomes in the treatment of acromioclavicular joint dislocation

Journal of International Medical Research ◽

10.1177/0300060518786910 ◽

2018 ◽

Vol 46 (11) ◽

pp. 4547-4559 ◽

Cited By ~ 1

Author(s):

Guanghui Li ◽

Tuoen Liu ◽

Xianfang Shao ◽

Zhijun Liu ◽

Jianhui Duan ◽

...

Keyword(s):

Clinical Outcomes ◽

Postoperative Recovery ◽

Hook Plate ◽

Acromioclavicular Joint Dislocation ◽

Ac Joint ◽

Level Of Evidence ◽

Joint Dislocation ◽

Ac Joint Dislocation ◽

Clavicular Hook Plate ◽

Retrospective Comparative Study

Objective Clavicular hook plate application is one of the most commonly used treatment methods for acromioclavicular (AC) joint dislocation, although it may cause multiple postoperative complications. We modified the regularly used 0° hook plate to 15° and compared the clinical outcomes of these two hook plates for treatment of AC joint dislocation. Methods Forty-three patients with acute AC joint dislocation were randomly enrolled (0° hook plate, 20 patients; 15° hook plate, 23 patients). The American Shoulder and Elbow Surgeons (ASES) and visual analog scale for pain (VASP) scores were evaluated preoperatively and at 3 days and 1, 2, 3, and 6 months postoperatively and compared between the two groups. Results Compared with the preoperative scores, the 6-month postoperative ASES score gradually increased but the VASP score decreased in both groups. Furthermore, the ASES and VASP scores were significantly different between the two groups at every postoperative time point. Conclusion The 15° hook plate is superior to the 0° hook plate in reducing shoulder pain and improving postoperative recovery in the treatment of AC joint dislocation. Level of evidence Level III; Treatment study (retrospective comparative study).

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Acute high-grade acromioclavicular joint dislocation patients treated with titanium cable insertion under a homemade guider

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02442-1 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Jun Wang ◽

Yongfeng Cui ◽

Yuhang Zhang ◽

Hang Yin

Keyword(s):

Acromioclavicular Joint ◽

Double Bundle ◽

Acromioclavicular Joint Dislocation ◽

High Grade ◽

Ac Joint ◽

Joint Dislocation ◽

X Ray ◽

Radiographic Outcomes ◽

Ac Joint Dislocation ◽

Coracoclavicular Distance

Abstract Backgrounds To describe a new technique for implanting a double-bundle titanium cable to treat acromioclavicular (AC) joint dislocation via the new guider, and evaluate clinic outcomes. Methods A retrospective study of patients treated for acute high-grade acromioclavicular joint dislocation from June 2016 to January 2020 in our trauma center, twenty patients with AC joint dislocation were managed with double-bundle titanium cable. It includes the following steps: (1) Put the guider under the coracoid close to the cortical; (2) drill proximal clavicle; (3) place the titanium cable; (4) perforate distal clavicle, (5) reset the acromioclavicular joint and lock titanium cable; and (6) suture the acromioclavicular ligament. An independent reviewer conducted functional testing of these patients, including the use of coracoclavicular distance (CCD), visual analog scale (VAS) scores, and Constant–Murley scores (CMS). Results All patients are presented following at a median duration of 15 months (12-24months) after the surgery. All patients based on X-ray evaluation and clinic evaluation. The median CCD was 7.5 (6–14) mm, the VAS score was 0.55 (0-2), the CMS score was 95.5 (92-99). One patient had subluxation again at the final follow-up based on X-ray examination. Conclusions This study demonstrates that the AC joint fixation anatomically with double-bundle titanium, acquired excellent outcomes in terms of the recovery of shoulder joint function and radiographic outcomes. It has a low complication rate and need not remove the hardware.

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Treatment of chronic acromioclavicular joint dislocation in a paraplegic patient with the Weaver-Dunn procedure and a hook-plate

Orthopedic Reviews ◽

10.4081/or.2016.6371 ◽

2016 ◽

Vol 8 (2) ◽

Cited By ~ 1

Author(s):

Holger Godry ◽

Mustafa Citak ◽

Matthias Königshausen ◽

Thomas A. Schildhauer ◽

Dominik Seybold

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Weight Bearing ◽

Full Range ◽

Hook Plate ◽

Acromioclavicular Joint Dislocation ◽

Ac Joint ◽

Joint Dislocation ◽

Ac Joint Dislocation ◽

Cord Injury

Abstract In case of patients with spinal cord injury and concomitant acromioclavicular (AC) jointdislocation the treatment is challenging, as in this special patient group the function of the shoulder joint is critical because patients depend on the upper limb for mobilization and wheelchair-locomotion. Therefore the goal of this study was to examine, if the treatment of chronic AC-joint dislocation using the Weaver- Dunn procedure augmented with a hook-plate in patients with a spinal cord injury makes early postoperative wheelchair mobilization and the wheelchair transfer with full weightbearing possible. In this case the Weaver- Dunn procedure with an additive hook-plate was performed in a 34-year-old male patient with a complete paraplegia and a posttraumatic chronic AC-joint dislocation. The patient was allowed to perform his wheelchair transfers with full weight bearing on the first postoperative day. The removal of the hook-plate was performed four months after implantation. At the time of follow-up the patient could use his operated shoulder with full range of motion without restrictions in his activities of daily living or his wheel-chair transfers.

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Ipsilateral midshaft clavicle fracture and acromioclavicular joint dislocation: a review of literature and evidence-based diagnosis guidelines

10.21203/rs.3.rs-36221/v1 ◽

2020 ◽

Author(s):

Rongguang Ao ◽

Zhen Jian ◽

Jinhong Chen ◽

Dejian Li ◽

Xu Zhang ◽

...

Keyword(s):

Clavicle Fracture ◽

High Energy ◽

Shoulder Function ◽

Acromioclavicular Joint Dislocation ◽

Evidence Based ◽

Ac Joint ◽

Level Of Evidence ◽

Joint Dislocation ◽

Type Iv ◽

Ac Joint Dislocation

Abstract Background: Ipsilateral midshaft clavicle fracture and AC joint dislocation are rare, with very few cases reported. Once the AC joint dislocation were missed diagnosis, the shoulder function may be affected and medical dispute was easy to occur. The aim of this study was to gather data relating to ipsilateral midshaft clavicle fracture and AC joint dislocation to develop evidence-based diagnosis guidelines as none are currently available.Methods: A study was conducted of the PubMed and Google Scholar databases to identify cases of ipsilateral midshaft clavicle fracture and AC joint dislocation. Data collected about each case included age and gender of the patient, mechanism of injury, fracture and dislocation classification. The authors report 2 additional ipsilateral midshaft clavicle fracture and AC joint dislocation cases.Results: 21 cases were identified for inclusion in this research, 19 from the literature and 2 reported by the authors. All the patients were injured by high energy trauma. For the midshaft fracture, 16/21 (76.2%) patients belonged to Type A classification, and 5/21 (23.8%) patients belonged to Type B classification. For AC joint dislocation, 11/21 (47.6%) patients belonged to Type IV classification, 4/21 (19.0%) patients belonged to Type VI classification, 5/21 (23.8%) patients belonged to Type III classification and 1/21 (4.7%) patients belonged to Type V classification.Conclusions: There are limited data available about the diagnosis of ipsilateral midshaft clavicle fracture and AC joint dislocation. From the cases reviewed, we find that simple midshaft clavicle caused by high energy injuries may be associated with ipsilateral AC joint dislocation. Physical examination, careful observation of preoperative X-ray and fluoroscopy including the AC joint during operation were key to diagnose the injury. Level of Evidence Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Acromion Fracture and Acromioclavicular Joint Dislocation: A Case Report

Journal of Orthopedic and Spine Trauma ◽

10.18502/jost.v4i4.3099 ◽

2020 ◽

Author(s):

Mohammad Zarei ◽

Saied Besharaty ◽

Alireza Moharrami ◽

Rasul Ghaedi

Keyword(s):

Acromioclavicular Joint Dislocation ◽

Early Recovery ◽

Ac Joint ◽

Early Management ◽

Case Presentation ◽

Joint Dislocation ◽

Ac Joint Dislocation ◽

Acromion Fracture ◽

Acromial Fracture ◽

Clavicle Fractures

Background: Acromion fractures are rare injuries that may occur because of shoulder trauma. This may be associated with distal clavicle fractures, which can be an indication for surgery. There are several methods, which are used for fixation of this type of fractures. Case Presentation: In this paper, we presented a 34 years old man with acromion fracture in contribution with acromioclavicular (AC) joint dislocation. We applied a new method for fixation of this fracture. The fracture was fixed by 2 screws and AC Joint was fixed by a 4-hole hook plate. Conclusions: It is important to be aware of acromial fracture to not miss them and also for early management, so that early recovery and satisfactory results can be gained

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