Clinical study on treatment of TOSSY type III acromioclavicular joint dislocation with clavicular hook plate combined with coracoclavicular ligament repair

Objective: To explore the treatment of TOSSY type III acromioclavicular joint dislocation with clavicular hook plate combined with coracoclavicular ligament repair and its clinical effect.Methods: 80 patients with TOSSY type III acromioclavicular joint dislocation who were admitted to our hospital from January 2014 to January 2019 were selected. They were randomly divided into the control group (n = 39, treated with clavicular hook plate) and the observation group (n = 41, treated with clavicular hook plate combined with coracoclavicular ligament repair) by the random number table method. The clinical efficacy in 12 months after operation, related clinical indicators, 12-month postoperative recovery and postoperative complications were compared between the two groups.Results: The excellent and good rate was 92.68% (38/41) in 12 months after operation in the observation group, which was higher than that (76.92%, 30/39) in the control group (p < .05). There were no significant differences in the duration of surgery, intraoperative blood loss and HLOS between the observation group and the control group (p > .05). In 12 months after operation, abduction activity and forward flexion activity of the observation group were higher than those of the control group, and visual analogue score (VAS) was lower than that of the control group (p < .05). The incidence of complications in the observation group was slightly lower than that in the control group, but there was no statistically significant difference between the two groups (p > .05).Conclusions: For TOSSY type III acromioclavicular joint dislocation, clavicular hook plate combined with coracoclavicular ligament repair has a good clinical efficacy. It can improve shoulder joint function, alleviate shoulder pain and have fewer complications. It can provide a reference for clinical treatment of this type of acromioclavicular joint dislocation.

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

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.

To explore the reasonable selection of clavicular hook plate to reduce the occurrence of subacromial impingement syndrome after operation

Background Acromioclavicular joint dislocation is a shoulder joint injury common in the clinical setting and is generally surgically treated with clavicular hook plate technique with confirmed curative effect. However, symptoms such as shoulder abduction limitation, shoulder discomfort and joint pain postoperatively may occur in some patients. Therefore, this study aimed to explore whether the existing clavicular hook plate can be reasonably selected to reduce the incidence of subacromial impingement syndrome (SIS) and provide a reference for clinical diagnosis and treatment. Materials and methods Patients with SIS admitted from March 2018 to June 2020 were selected as the experimental group and asymptomatic patients postoperatively, as the control group. The hook end depth and acromial height of the hook plate used in patients were recorded, and the difference between them was calculated. Results The difference between the hook plate depth and acromial height was 7.500±1.912 mm and 6.563±1.537 mm in the experimental and control groups, respectively, with statistically significant difference (t=3.021, P=0.006). A difference of >0.6 mm as a grouping index is required to perform a single factor analysis, with statistically significant difference (t=3.908, P=0.048). Conclusions The occurrence of SIS after placing the clavicular hook plate may be related to the difference between its depth and the acromial height. A difference of >6 mm may be a factor affecting the occurrence of SIS. Pre-imaging measurement of the acromial height can provide suggestions for selecting the type of hook plate intraoperatively.

Triple-Endobutton and clavicular hook: A propensity score matching analysis

We retrospectively analyzed the clinical data of 635 patients with acute acromioclavicular dislocation, who underwent surgery in our hospital between May 2014 and June 2020. Patients were divided into group A (clavicular hook plate) and group B (Triple-Endobutton plates via double-incision). The propensity score analysis using one to one match was performed for comparisons. We obtained 292 matched patients’ data. The matched preoperative clinical characteristics were a balance between the two groups. All clinical parameters showed insignificant differences (P > 0.05). Compared with group A, group B has longer operative time (P < 0.001) and more blood loss (P < 0.001); however, the mean incision length (P < 0.001) and length of hospitalization (P < 0.001) were shorter in group B than in the group A. The mean VAS in group B were significantly lower than in group A at each time point (P < 0.001), and the UCLA shoulder score was higher in the group B. The CMS scores were also higher in group B than in group A, including before removal and 12 weeks after removal (P < 0.001). The clinical efficacy of the double-incision Triple-Endobutton plate is better than the clavicular hook plate technology, and achieves anatomical reduction by reconstructing coracoclavicular ligament.

Effectiveness of Surgical Treatment of Rockwood Type III Acromioclavicular Joint Dislocation Using Clavicle Hook Plate and Tension Band Wiring: A Comparative Study to Evaluate the Functional and Surgical Outcome

Introduction: Acromioclavicular joint dislocation Type III is still controversial for its management, despite of numerous trials and reviews. Aims: To compare and evaluate the functional and surgical outcome of Rockwood Type III acromioclavicular joint dislocation treated surgically with clavicular Hook plate and Tension Band wiring with K-wires. Methods: In a prospective hospital based interventional study comprising of total 22 patients with a mean age of 31.36 ± 7.53 years who presented with Rockwood Type III acromioclavicular joint dislocation were carried between January 2018 to December 2019. They were graded according to Rockwood et al. classification. All 22 patients underwent open reduction and internal fixation. These patients were divided into two groups according to operative procedure; of which 11 patients were treated with clavicular hook plate (CHP) and rest 11 were treated with tension band wiring with K-wires (TBW). Descriptive comparison was tabulated during pre-operative, intra-operative and post-operative periods. The Constant-Murley Shoulder scoring system was applied for evaluating the results. Results: The mean follow up period was 7.6 months. The clavicular hook plate was removed at 10 months in one patient due to severe pain and limited range of motion , and removal of Tension Band wiring with K-wires were done in two patients due to wound dehiscence and Kirschner wire back out at 5 and 6 months. The mean Constant- Murley shoulder score was 82.6 (min. 70 & max. 93) in clavicular hook plate and 74.72 (min 68 & max. 84) in Tension band wiring with K-wires which found to be significantly difference in mean scoring between two groups. Conclusion: Patients treated with Clavicular Hook Plate for Rockwood Type III acromioclavicular joint dislocation had a very good functional and surgical outcome over Tension Band wiring with K-wires.

To Explore the Reasonable Selection of Clavicular Hook Plate to Reduce the Occurrence of Subacromial Impingement Syndrome After Operation.

Purpose:To explore whether the existing clavicular hook plate can be reasonably selected to reduce the incidence of Subacromial impingement syndrome （SIS） and provide reference for clinical diagnosis and treatment.Methods and methods The patients with SIS admitted from March 2019 to March 2020 were selected as the experimental group, and the asymptomatic patients after operation as the control group. The hook end depth and acromion height of the hook plate used by the patients were recorded, and the difference between them was calculated.Results The difference between the depth of hook plate and the height of acromion in the experimental group was (8.06±1.15mm). In the control group, the difference between the depth of hook plate and the height of acromion was (6.78±1.82mm), and the difference was statistically significant（t=2.721，P=0.009）. The difference is greater than 0.6 mm as a grouping index to do a single factor analysis）.The difference was statistically significant（t=5.711 P=0.017）.Conclusions The occurrence of SIS after clavicular hook plate may be related to the difference between the depth of hook plate and the height of acromion. When the difference is greater than 6mm, it may be a factor affecting the occurrence of SIS. Pre-imaging measurement of acromion height can provide suggestions for selecting the type of hook plate during operation.