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International Orthopaedics

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01-12-2017 | Original Paper

Outcomes of surgery for acromioclavicular joint dislocation using different angled hook plates: a prospective study

Authors: Ding Xu, Peng Luo, Jukun Chen, Liefeng Ji, Luxu Yin, WeiKang Wang, Jiang Zhu

Published in: International Orthopaedics | Issue 12/2017

Abstract

Purpose

Hook plate fixation is widely used to treat acromioclavicular joint dislocation. However, there are many post-operative complications affecting the effect of treatment. The aim of this study is to evaluate the efficacy of the clavicular hook plate with different hook angles as a method of treatment in AC joint dislocation, and to guide the clinical application of hook plate.

Methods

We prospectively analysed 54 patients who were diagnosed with AC joint dislocation and treated with hook plate fixation by different hook angles. The patients were randomised into three groups: the −20° < AHP < 0° group, the 20° > AHP > 0° group and the 40° > AHP > 20° group. All patients were required to conform to regular follow-up post-operatively. Routine imaging to the shoulder was obtained to evaluate maintenance of the dislocation and the implant. Constant-Murley criteria were used to evaluate functional results.

Results

There were 19 patients in the −20° < AHP < 0° group, with one lost to follow-up, 22 patients in the 20° > AHP > 0° group, with two male patients lost to follow-up, and one female patient excluded because of no follow-up consent, and 19 patients in the 40° > AHP > 20° group, with one female and one male patient lost to follow-up. The Constant score was 61.8 ± 12.8, 74.7 ± 9.2 and 70.7 ± 9.4 before implant removal, and 78.8 ± 8.3, 87.1 ± 6.4 and 85.0 ± 6.1 after implant removal in the −20° < AHP < 0°, 20° > AHP > 0° and 40° > AHP > 20° groups, respectively. The functional results of the 20° > AHP > 0° and 40° > AHP > 20° groups were significantly better than the −20° < AHP < 0° group (P < 0.05), but the functional results of the 20° > AHP > 0° and 40° > AHP > 20° groups were not statistically significant. The CCD was 98.1 ± 4.8%, 107.5 ± 5.1% and 105.5 ± 4.1% before implant removal, and 98.8 ± 4.6%, 108.3 ± 4.8% and 107.2 ± 3.3% after implant removal in the three groups, respectively. The CCD of the 20° > AHP > 0° and 40° > AHP > 20° groups were statistically significantly different from the −20° < AHP < 0° group (P < 0.001). However, there was no statistical difference between the 20° > AHP > 0° group and the 40° > AHP > 20° group. Post-operative persistent pain occurred in 18.5% of all patients, post-operative stiffness occurred in 25.9% of all patients and 24.0% of patients had subacromial erosion.

Conclusions

Hook plate treatment for AC joint dislocation can achieve the desired results, but the efficacy was significantly different depending on the different angles of the hook plate. AHP should be controlled within the range of 0–40° as much as possible when making clinical decisions.

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Title: Outcomes of surgery for acromioclavicular joint dislocation using different angled hook plates: a prospective study
Authors: Ding Xu
Peng Luo
Jukun Chen
Liefeng Ji
Luxu Yin
WeiKang Wang
Jiang Zhu
Publication date: 01-12-2017
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 12/2017
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-017-3611-2

At a glance: The STEP trials

Springer Medicine

Outcomes of surgery for acromioclavicular joint dislocation using different angled hook plates: a prospective study

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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