DOI QR코드

DOI QR Code

A Novel Fluoroscopic View for Positioning the AO Clavicle Hook Plate Decreases Its Associated in situ Complications

  • Hyun, Yoon-Suk (Department of Orthopaedic Surgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Kim, Gab-Lae (Department of Orthopaedic Surgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Choi, Sang-Min (Department of Orthopaedic Surgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Shin, Woo-Jin (Department of Orthopaedic Surgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Seo, Dong-Yeon (Department of Orthopaedic Surgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine)
  • Received : 2015.10.04
  • Accepted : 2015.12.26
  • Published : 2016.03.31

Abstract

Background: The goal of this study was to evaluate whether a modified fluoroscopic technique for positioning a hook plate affected the clinical results of treating Neer type II distal clavicle fractures and Rockwood type V acromioclavicular (AC) joint separations with this device. Methods: The study was a retrospective consecutive case series with data analysis. Sixty-four patients with a Neer type II distal clavicle fracture or a Rockwood type V AC joint injury treated between March 2009 and June 2013 were divided into 2 groups: traditional fluoroscopic technique (traditional view, 31 patients) or modified fluoroscopic technique ('hook' view, 33 patients). A visual analogue scale (VAS) score, the modified University of California-Los Angeles (UCLA) shoulder scale score, and radiographic osteolysis were the main outcome measures. Results: The traditional group included a significantly larger number of patients with acromial osteolysis than the hook view group: 23 patients (74.2%) vs. 11 patients (33.3%), respectively (p=0.01). Before plate removal, the hook group reported less pain and higher UCLA shoulder scale scores than the traditional group: average VAS score, 1.55 vs. 2.26, respectively; average UCLA score, 30.88 vs. 27.06, respectively. However, there was no significant difference after plate removal. Conclusions: The hook view allows more accurate bending of the hook plate around the contour of the acromion, resulting in decreased osteolysis, decreased pain, and better function with the plate in situ.

Keywords

References

  1. Neer CS 2nd. Fracture of the distal clavicle with detachment of the coracoclavicular ligaments in adults. J Trauma. 1963;3: 99-110. https://doi.org/10.1097/00005373-196303000-00001
  2. Rockwood CA Jr. Injuries to the acromioclavicular joint. Part II: subluxations and dislocations about the shoulder. In: Rockwood CA Jr, Green DP, eds. Fractures in adults. Vol. 1. 2th ed. Philadelphia: JB Lippincott; 1984. 860-5.
  3. Boileau P, Old J, Gastaud O, Brassart N, Roussanne Y. Allarthroscopic Weaver-Dunn-Chuinard procedure with doublebutton fixation for chronic acromioclavicular joint dislocation. Arthroscopy. 2010;26(2):149-60. https://doi.org/10.1016/j.arthro.2009.08.008
  4. De Baets T, Truijen J, Driesen R, Pittevils T. The treatment of acromioclavicular joint dislocation Tossy grade III with a clavicle hook plate. Acta Orthop Belg. 2004;70(6):515-9.
  5. Macheras G, Kateros KT, Savvidou OD, Sofianos J, Fawzy EA, Papagelopoulos PJ. Coracoclavicular screw fixation for unstable distal clavicle fractures. Orthopedics. 2005;28(7):693-6.
  6. Martetschläger F, Kraus TM, Schiele CS, et al. Treatment for unstable distal clavicle fractures (Neer 2) with locking T-plate and additional PDS cerclage. Knee Surg Sports Traumatol Arthrosc. 2013;21(5):1189-94. https://doi.org/10.1007/s00167-012-2089-0
  7. Murena L, Vulcano E, Ratti C, Cecconello L, Rolla PR, Surace MF. Arthroscopic treatment of acute acromioclavicular joint dislocation with double flip button. Knee Surg Sports Traumatol Arthrosc. 2009;17(12):1511-5. https://doi.org/10.1007/s00167-009-0838-5
  8. Scheibel M, Dröschel S, Gerhardt C, Kraus N. Arthroscopically assisted stabilization of acute high-grade acromioclavicular joint separations. Am J Sports Med. 2011;39(7):1507-16. https://doi.org/10.1177/0363546511399379
  9. Weaver JK, Dunn HK. Treatment of acromioclavicular injuries, especially complete acromioclavicular separation. J Bone Joint Surg Am. 1972;54(6):1187-94. https://doi.org/10.2106/00004623-197254060-00005
  10. Di Francesco A, Zoccali C, Colafarina O, Pizzoferrato R, Flamini S. 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. Injury. 2012;43(2): 147-52. https://doi.org/10.1016/j.injury.2011.04.002
  11. Renger RJ, Roukema GR, Reurings JC, Raams PM, Font J, Verleisdonk EJ. The clavicle hook plate for Neer type II lateral clavicle fractures. J Orthop Trauma. 2009;23(8):570-4. https://doi.org/10.1097/BOT.0b013e318193d878
  12. Tan HL, Zhao JK, Qian C, Shi Y, Zhou Q. Clinical results of treatment using a clavicular hook plate versus a Tplate in neer type II distal clavicle fractures. Orthopedics. 2012;35(8):e1191-7. https://doi.org/10.3928/01477447-20120725-18
  13. Tiren D, van Bemmel AJ, Swank DJ, van der Linden FM. Hook plate fixation of acute displaced lateral clavicle fractures: midterm results and a brief literature overview. J Orthop Surg Res. 2012;7:2. https://doi.org/10.1186/1749-799X-7-2
  14. von Heideken J, Boström Windhamre H, Une-Larsson V, Ekelund A. Acute surgical treatment of acromioclavicular dislocation type V with a hook plate: superiority to late reconstruction. J Shoulder Elbow Surg. 2013;22(1):9-17. https://doi.org/10.1016/j.jse.2012.03.003
  15. Chandrasenan J, Badhe S, Cresswell T, Beer JD. The clavicular hook plate: consequences in three cases. Eur J Trauma Emergency Surg. 2007;33(5):557-9. https://doi.org/10.1007/s00068-006-6028-y
  16. ElMaraghy AW, Devereaux MW, Ravichandiran K, Agur AM. Subacromial morphometric assessment of the clavicle hook plate. Injury. 2010;41(6):613-9. https://doi.org/10.1016/j.injury.2009.12.012
  17. Meda PV, Machani B, Sinopidis C, Braithwaite I, Brownson P, Frostick SP. Clavicular hook plate for lateral end fractures:- a prospective study. Injury. 2006;37(3):277-83. https://doi.org/10.1016/j.injury.2005.10.017
  18. Muramatsu K, Shigetomi M, Matsunaga T, Murata Y, Taguchi T. Use of the AO hook-plate for treatment of unstable fractures of the distal clavicle. Arch Orthop Trauma Surg. 2007;127(3): 191-4. https://doi.org/10.1007/s00402-006-0284-5
  19. Tambe AD, Motkur P, Qamar A, Drew S, Turner SM. Fractures of the distal third of the clavicle treated by hook plating. Int Orthop. 2006;30(1):7-10. https://doi.org/10.1007/s00264-005-0019-1
  20. Marsh JL, Slongo TF, Agel J, et al. Fracture and dislocation classification compendium - 2007: Orthopaedic Trauma Association classification, database and outcomes committee. J Orthop Trauma. 2007;21(10 Suppl):S1-133. https://doi.org/10.1097/00005131-200711101-00001
  21. Nutton RW, McBirnie JM, Phillips C. Treatment of chronic rotator-cuff impingement by arthroscopic subacromial decompression. J Bone Joint Surg Br. 1997;79(1):73-6. https://doi.org/10.1302/0301-620X.79B1.7225
  22. Bhangal KK, Evans SC, Gibbons CE. Treatment of displaced lateral clavicle fractures with the AO hook plate. Eur J Trauma. 2006;32(5):468-70. https://doi.org/10.1007/s00068-006-6012-6
  23. Hackenberger J, Schmidt J, Altmann T. The effects of hook plates on the subacromial space: a clinical and MRT study. Z Orthop Ihre Grenzgeb. 2004;142(5):603-10. https://doi.org/10.1055/s-2004-832323
  24. Lee KW, Lee SK, Kim KJ, Kim YI, Kwon WC, Choy WS. Arthroscopic- assisted locking compression plate clavicular hook fixation for unstable fractures of the lateral end of the clavicle: a prospective study. Int Orthop. 2010;34(6):839-45. https://doi.org/10.1007/s00264-009-0925-8
  25. Flinkkila T, Ristiniemi J, Lakovaara M, Hyvonen P, Leppilahti J. Hook-plate fixation of unstable lateral clavicle fractures: a report on 63 patients. Acta Orthop. 2006;77(4):644-9. https://doi.org/10.1080/17453670610012737
  26. Good DW, Lui DF, Leonard M, Morris S, McElwain JP. Clavicle hook plate fixation for displaced lateral-third clavicle fractures (Neer type II): a functional outcome study. J Shoulder Elbow Surg. 2012;21(8):1045-8. https://doi.org/10.1016/j.jse.2011.07.020
  27. Lee YS, Lau MJ, Tseng YC, Chen WC, Kao HY, Wei JD. Comparison of the efficacy of hook plate versus tension band wire in the treatment of unstable fractures of the distal clavicle. Int Orthop. 2009;33(5):1401-5. https://doi.org/10.1007/s00264-008-0696-7
  28. Salem KH, Schmelz A. Treatment of Tossy III acromioclavicular joint injuries using hook plates and ligament suture. J Orthop Trauma. 2009;23(8):565-9. https://doi.org/10.1097/BOT.0b013e3181971b38
  29. Armstrong AD, MacDermid JC, Chinchalkar S, Stevens RS, King GJ. Reliability of range-of-motion measurement in the elbow and forearm. J Shoulder Elbow Surg. 1998;7(6):573-80. https://doi.org/10.1016/S1058-2746(98)90003-9
  30. Riddle DL, Rothstein JM, Lamb RL. Goniometric reliability in a clinical setting. Shoulder measurements. Phys Ther. 1987; 67(5):668-73. https://doi.org/10.1093/ptj/67.5.668

Cited by

  1. Is Bending the Hook Plate Necessary in Acromioclavicular Joint Dislocation? vol.24, pp.4, 2016, https://doi.org/10.5397/cise.2021.00640