Abstract

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.

Highlights

  • A clavicle hook plate is widely used to treat acromioclavicular dislocation and distal clavicle fracture [1,2,3,4,5,6], as its unique hook shape can provide a good stability and partial rotational mobility of the acromioclavicular joint [7]

  • When the same force is mid-third of the clavicle, which may increase the risk of peri-implant fracture [10,12,13]

  • Given the experimental design of this study, it was unable to prove directly that variations in the posterior hook offset led to peri-implant fracture or subacromial osteolysis; this study can still explain that the posterior hook offset made the biomechanical difference in the strain on the clavicle. These assumptions are slightly different from the actual situation, this study evaluated the biomechanical trends of the implantation of clavicle hook plates with different posterior hook offsets at various positions in the acromion

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Summary

Introduction

A clavicle hook plate is widely used to treat acromioclavicular dislocation and distal clavicle fracture [1,2,3,4,5,6], as its unique hook shape can provide a good stability and partial rotational mobility of the acromioclavicular joint [7] It is a convenient, simple, and effective treatment [5,6], some complications still occur, such as subacromial osteolysis [8,9,10], rotator cuff impingement [11], rotator cuff tear [11], and peri-implant fracture [10,12,13,14,15].

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