Abstract

To determine the incidence of subacromial erosion, perform quantitative analysis, and identify risk factors after locking hook plate fixation for acute acromioclavicular joint injury. A retrospective case series study. A single tertiary university hospital. The study was conducted on 35 patients who had acute acromioclavicular joint injury. Patients underwent the locking hook plate fixation. The computed tomography (CT) was conducted to measure the subacromial erosion. The acromioclavicular slope (AC slope) of the unaffected side, the acromion-hook angle, the acromioclavicular anteroposterior distance (AC-AP distance), and the preoperative acromioclavicular interval of the affected side were analyzed to identify the risk factors of subacromial erosion. According to the CT findings, subacromial erosion was found in all cases, and the mean value was 5.0 mm, which is 53% of the entire acromion thickness. The AC slope (B = -0.159, P < 0.001) and AC-AP distance (B = 0.233, P = 0.004) were found to have a significant influence on postoperative subacromial erosion. The AC slope showed a negative correlation with the amount of erosion, whereas the AC-AP distance showed a positive correlation with erosion. The CT findings revealed that subacromial erosion occurred in all cases, and the mean erosion depth was about 50% of the acromial thickness. If the preoperative AC slope of the unaffected side was more acute and the AC-AP distance was larger, the incidence of subacromial erosion was higher. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Highlights

  • This study was to analyze the clinical results of locking hook plate fixation for acute acromioclavicular joint (ACJ) injury and to find out the incidence of subacromial erosion, carry out quantitative analysis and identify risk factors

  • The most common injury mechanism of the ACJ injury is considered as an external force applied directly from above the acromion process, which usually occurs when falling with the upper limb in an adducted position.[2]

  • This study retrospectively examined those patients who underwent hook plate fixation for acute ACJ injury at our hospital from January 2011 to October 2015

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Summary

Introduction

This study was to analyze the clinical results of locking hook plate fixation for acute acromioclavicular joint (ACJ) injury and to find out the incidence of subacromial erosion, carry out quantitative analysis and identify risk factors. About half of the ACJ injuries occur in young people in their 20s, and the incidence among males is 5 times higher than among females.[1] The most common injury mechanism of the ACJ injury is considered as an external force applied directly from above the acromion process, which usually occurs when falling with the upper limb in an adducted position.[2] Among ACJ injuries, incomplete injuries which belong to Rockwood type. There is still much controversy over optimal treatments for higher grader injuries which belong to Rockwood type III~VI.[3,4,5].

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