hook plate
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2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Ho-Seok Oh ◽  
Sungmin Kim ◽  
Jeong-Hun Hyun ◽  
Myung-Sun Kim

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.


TRAUMA ◽  
2021 ◽  
Vol 22 (6) ◽  
pp. 4-9
Author(s):  
О.A. Buryanov ◽  
V.P. Kvasha ◽  
D.A. Сhekushyn ◽  
V.O. Naumenko

Background. Acromioclavicular dislocation is a fairly common traumatic injury of the musculoskeletal system, and according to different authors varies from 2 to 26.1 % dislocations of other localizations, and is about 10 % of all acute injuries of the shoulder girdle, taking 3rd place after dislocations of shoulder and forearm. The social significance of this damage is determined by the occurrence mainly among young working-age men. The work was aimed to identify factors that cause unsatisfactory anatomical and functional results after surgical treatment of acromioclavicular dislocations. Materials and methods. This retrospective study (2015–2020) included 93 patients who had surgical intervention for acromioclavicular dislocation. Surgical stabilization of the acromial end of the clavicle was done by Hook Plate and by Weber technic. Results. The outcome of research shows that 49.5 % of cases had good results, 31.2 % — satisfactory, and 19.3 % — poor. There is a direct correlation between unsatisfying outcome and increased severity of the injury. The study found that 9.7 % of unsatisfying results were associated while using Weber’s technic in the Tossy II, while in Tossy III, it was 27.0 %. A similar correlation was found while using Hook Platе, in the case of Tossy II, unsatisfying results were in 15.8 % of cases and Tossy III — 29.4 %. Conclusions. The reason for the unsatisfying results of the surgical acromioclavicular dislocations treatment is the severity of damage and the absence of an algorithm for diagnosis and management of this injury. In Tossy III dislocations, the use of stabilization methods as Weber’s technic, Hook Plate, or suturing damaged acromioclavicular ligaments did not demonstrate satisfying effectiveness.


2021 ◽  
Vol 11 (23) ◽  
pp. 11105
Author(s):  
Li-Kun Hung ◽  
Cheng-Hung Lee ◽  
Kuo-Chih Su

The clavicle hook plate is commonly used in acromioclavicular injuries; however, the biomechanical effect of the posterior hook offset and hook position is unclear. This study applied a finite element analysis (FEA) to evaluate these parameters to improve the clinical strategy. Nine FEA models with 0-mm, 5-mm, and 10-mm posterior hook offsets implanted in the anterior, middle, and posterior acromion were established to evaluate the stress distribution and the reaction force on the acromion. The 5-mm and 10-mm posterior hook offsets at all acromion positions reduced the reaction force on the acromion but slightly increased the stress on the clavicle. The 0-mm offset increased the reaction force at all acromion positions and was relatively lower at the middle acromion. The clavicle hook plate with a posterior hook offset reduces the reaction force on the acromion, providing a flexibility of the hook position. These results provide surgeons with the biomechanical basis for the hook offset and position and engineers with the mechanical basis for the implant design.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Qi Sun ◽  
Ming Cai ◽  
Xiaoming Wu

Abstract Background Os acromiale can be potentially missed or misdiagnosed as acromion fracture, and this can affect treatment determination if it is complicated with an ipsilateral shoulder injury. The clavicle hook plate is a widely used technique for distal clavicle injuries, leading to transacromial erosion, particularly when in the presence of os acromiale. Case presentation A 70-year-old man and a 78-year-old man who had limited mobility and severe pain in their right shoulders following falls attended the emergency center. Both patients were diagnosed with os acromiale with CT or MRI and acute distal clavicle fracture or acromioclavicular joint dislocation. Following a comprehensive evaluation, os acromiale may limit the application of a clavicle hook plate due to potential transacromial erosion. The distal clavicle fracture with ipsilateral os acromiale received treatment with a volar radius locking T plate, and the acromioclavicular joint dislocation with ipsilateral os acromiale was reconstructed using suture anchors. Both yielded satisfactory outcomes and voided transacromial erosion. Conclusions Ipsilateral os acromiale may be a relative contraindication to the clavicle hook plate. An axillary lateral radiograph is recommended to detect potential os acromiale in patients using a hook plate.


Cureus ◽  
2021 ◽  
Author(s):  
Josh A Hansen ◽  
John C Dunn ◽  
John P Scanaliato ◽  
Joshua Caruso ◽  
Nata Z Parnes

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