Effects of hook plate on shoulder function after treatment of acromioclavicular joint dislocation.

INTRODUCTION Internal fixation with hook plate has been used to treat acromioclavicular joint dislocation. This study aims to evaluate the effect of its use on shoulder function, to further analyze the contributing factors, and provide a basis for selection and design of improved internal fixation treatment of the acromioclavicular joint dislocation in the future. METHODS A retrospective analysis was performed on patients treated with a hook plate for acromioclavicular joint dislocation in our hospital from January 2010 to February 2013. There were 33 cases in total, including 25 males and 8 females, with mean age of 48.27 ± 8.7 years. There were 29 cases of Rockwood type III acromioclavicular dislocation, 4 cases of type V. The Constant-Murley shoulder function scoring system was used to evaluate the shoulder function recovery status after surgery. Anteroposterior shoulder X-ray was used to assess the position of the hook plate, status of acromioclavicular joint reduction and the occurrence of postoperative complications. RESULTS According to the Constant-Murley shoulder function scoring system, the average scores were 78 ± 6 points 8 to 12 months after the surgery and before the removal of the hook plate, the average scores were 89 ± 5 minutes two months after the removal of hook plate. Postoperative X-ray imaging showed osteolysis in 10 cases (30.3%), osteoarthritis in six cases (18.1%), osteolysis associated with osteoarthritis in four cases(12.1%), and steel hook broken in one case (3%). CONCLUSION The use of hook plate on open reduction and internal fixation of the acromioclavicular joint dislocation had little adverse effect on shoulder function and is an effective method for the treatment of acromioclavicular joint dislocation. Osteoarthritis and osteolysis are the two common complications after hook plate use, which are associated with the impairment of shoulder function. Shoulder function will be improved after removal of the hook plate.

[1]  M. Balke,et al.  [Acute acromioclavicular joint injuries. Changes in diagnosis and therapy over the last 10 years]. , 2015, Der Unfallchirurg.

[2]  W. Ho,et al.  Clavicular hook plate may induce subacromial shoulder impingement and rotator cuff lesion - dynamic sonographic evaluation , 2014, Journal of Orthopaedic Surgery and Research.

[3]  A. Ekelund,et al.  Acute surgical treatment of acromioclavicular dislocation type V with a hook plate: superiority to late reconstruction. , 2013, Journal of shoulder and elbow surgery.

[4]  C. Zoccali,et al.  The use of hook plate in type III and V acromio-clavicular Rockwood dislocations: clinical and radiological midterm results and MRI evaluation in 42 patients. , 2012, Injury.

[5]  Wan-jun Zhao,et al.  [Case-control study on endobutton plate or clavicular hook plate for the repair of acromioclavicular joint dislocations]. , 2012, Zhongguo gu shang = China journal of orthopaedics and traumatology.

[6]  C. Queitsch,et al.  Mid-term results after operative treatment of rockwood grade III-V Acromioclavicular joint dislocations with an AC-hook-plate , 2011, European journal of medical research.

[7]  A. Agur,et al.  Subacromial morphometric assessment of the clavicle hook plate. , 2010, Injury.

[8]  T. Lind,et al.  Surgical treatment of acute and chronic acromioclavicular dislocation Tossy type III and V using the Hook plate. , 2008, Acta orthopaedica Belgica.

[9]  H. Resch,et al.  Rockwood type III acromioclavicular dislocation: surgical versus conservative treatment. , 2008, Journal of shoulder and elbow surgery.

[10]  R. Zdero,et al.  Methods of Operative Fixation of the Acromio-Clavicular Joint: A Biomechanical Comparison , 2007, Journal of orthopaedic trauma.

[11]  E Y Chao,et al.  Scapular and clavicular kinematics during humeral elevation: a study with cadavers. , 2001, Journal of shoulder and elbow surgery.

[12]  A. M. Phillips,et al.  Acromioclavicular dislocation : Conservative or surgical therapy : Controversies in Skeletal Trauma , 1998 .

[13]  C. Constant,et al.  A clinical method of functional assessment of the shoulder. , 1987, Clinical orthopaedics and related research.