Abstract
BackgroundThe aim of this study is to investigate the anatomic changes in the shoulder joints responsible for omalgia after the clavicular hook plate fixation under arthroscope.MethodsArthroscopic examination was carried out for 12 omalgia patients who underwent clavicular hook plate fixation due to distal clavicle fractures. Functional outcome of shoulder was measured by the Japanese Orthopaedic Association (JOA) score before and after the withdrawal of the fixation plate.ResultsThe rotator cuff compression by the clavicular hook was arthroscopically observed in 11 of the 12 cases. The JOA scores of the shoulder were significantly improved at 1 month after the withdrawal of the fixation plate (pain, 28 ± 2.4 vs. 15 ± 5.2; function, 19.2 ± 1.0 vs. 11.7 ± 1.9; range of movements, 26.8 ± 2.6 vs. 14.8 ± 3.4) compared with before.ConclusionsThe impingement of the hook to the rotator cuff may be the main cause for the omalgia. The appropriate hook and plate that fit to the curve of the clavicle as well as the acromion are necessary to decrease the severity of omalgia.
Highlights
Distal clavicle fractures account for approximately 10%– 26% of all the clavicle fractures, which can be mainly caused by car accidents and sports injuries [1]
Neer further divides the distal clavicle fractures into three types according to the relation of the fracture line to the coracoclavicular ligaments, among which type II fractures occur medially (IIA) or laterally (IIB) to the coracoclavicular ligaments and often result in major displacement because of complete or incomplete rupture of the coracoclavicular ligaments [2]
It is hypothesized that the omalgia after the clavicular hook plate fixation results from the mechanical hook impingement on the subacromial shoulder and rotator cuff based on radiography [13], magnetic resonance imaging (MRI) [14,15], and sonography [11,16]
Summary
Distal clavicle fractures account for approximately 10%– 26% of all the clavicle fractures, which can be mainly caused by car accidents and sports injuries [1]. Non-surgical strategies can be effective for the treatment of type II distal clavicle fractures, they lead to higher non-union rates (> 30%) [3,4,5]. It is hypothesized that the omalgia after the clavicular hook plate fixation results from the mechanical hook impingement on the subacromial shoulder and rotator cuff based on radiography [13], magnetic resonance imaging (MRI) [14,15], and sonography [11,16]. We aimed to further evaluate the anatomic changes in 12 patients who underwent AO clavicular hook plate fixation for distal clavicle fractures and suffered from postoperative omalgia using arthroscopy. The aim of this study is to investigate the anatomic changes in the shoulder joints responsible for omalgia after the clavicular hook plate fixation under arthroscope
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