OBJECTIVEHill-Sachs lesions are considered as an a priori risk factor for glenohumeral instability. Determination of glenoid and coracoacromial arch morphometric properties of patients with Hill-Sachs lesions may aid in the diagnosis, identification of optimal treatment strategies and prevention of recurrence.METHODSComputed tomography (CT) images of individuals between the ages of 20–40 were examined and the morphometric characteristics of the 39 patients with Hill-Sachs lesions and 71 control patients with healthy shoulder structures were compared. Glenoid inclination (GI), acromio-humeral distance (AHD), glenoid height (GH), glenoid superior width (GWs), glenoid inferior width (GWi), glenoid surface (GS), coraco-acromial distance (CAD), coraco-glenoid distance (CGD) and acromio-glenoid distance (AGD) were determined as morphometric features.RESULTSThe average values of the measurements in Hill-Sachs and control groups, respectively, were; glenoid inclination (1.06±6.61°; 4.33±6.20°), acromio-humeral distance (6.66±1.26; 7.67±1.64 mm), glenoid height (33.90±2.34; 35.03±3.29 mm), glenoid superior width (19.89±5.89; 19.83±2.37 mm), glenoid inferior width (24.28±2.53; 26.04±3.06 mm), glenoid surface (647.93±91.26; 721.58±136.86 mm2), coraco-acromial distance (40.24±3.99; 38.10±3.80 mm), coraco-glenoid distance (29.39±3.64; 29.96±4.44 mm) and acromio-glenoid distance (31.44±3.45; 31.64–33.56 mm). Glenoid inclination (p=0.011), acromio-humeral distance (p=0.001), glenoid height (p=0.039), glenoid inferior width (p=0.001), glenoid surface area (p=0.002) and coraco-acromial distance (p=0.008) were significantly different between the groups.CONCLUSIONThe glenoid and coracoacromial arch morphometry showed significant differences in patients with Hill-Sachs lesions. Recognizing these differences can reduce recurrence rates by reducing risk factors in the treatment of glenohumeral instability and providing the closest anatomical integrity to normal.

Identifying distinct scapular upward rotation patterns in individuals with upper trapezius-associated neck pain using unsupervised clustering approach.

Scapular morphological variations and sex-related and generational differences in global scapular shape: three-dimensional morphometric analysis using a homologous model

BackgroudSubacromial erosion and impingement syndrome are frequently reported complications following clavicle hook plate (CHP) fixation in Thai orthopedic practice. These complications may result from CHP designs that do not adequately accommodate the acromioclavicular joint (ACJ) anatomy of the Thai population. Currently, only 2 CHP sizes (12 mm and 15 mm in depth) with a 0° angle are commercially available, potentially increasing the risk of osteolysis due to direct point contact with the acromion. This study aimed to determine the average depth and angle of the ACJ in the Thai population to optimize CHP design.MethodsThis study analyzed 74 embalmed Thai cadavers (39 males and 35 females) donated for medical research. ACJ depth and inclination angle were measured bilaterally using 2 modified metric gauges constructed from stainless steel. The hanging hook of the depth measurement device was inserted close to the posterior ACJ before measuring the distance between the acromion process and the superior surface of the distal clavicle. The hypothetical ACJ angle was measured by reading at the scale on a standard protractor that complied with the matric tools.ResultsThe mean ACJ depth in Thai cadavers was 12.02 ± 4.11 mm (95% CI, 11.06–12.97 mm), while the mean inclination angle was 16.90° ± 6.76° (95% CI, 15.33°–18.46°). Males had significantly greater ACJ depth (14.06 ± 3.69 mm) compared to females (9.74 ± 3.31 mm, p < 0.01), but no significant difference was found between left and right clavicles. The ACJ inclination angle did not differ significantly between sexes. However, it was shown that the right ACJ angle (20.91° ± 6.94°) of Thais was significantly wider than the left side (14.05° ± 4.96°).ConclusionsThe optimal ACJ depth in the Thai population remains within the commercially available range of 12 to 15 mm. However, a CHP with an inclination angle of approximately 16° may help reduce postoperative complications such as subacromial erosion and impingement syndrome. The differences in ACJ depth between sexes and angle between sides should also be clinically considered before fixation.

Background. The specific proportion of dislocations of the acromial end of the clavicle is up to 26 % of traumatic dislocations of the locomotor system and up to 10 % of traumatic lesions in the shoulder girdle. In world practice, the need to fix the acromial end of the clavicle is realized by using hook plates in 47 % of cases. However, this design, along with its advantages, has significant disadvantages, the most significant of them are shoulder pain, bone destruction, especially in the area of the acromion, and subacromial conflict. Objective: to establish the relationship between the negative consequences and the design features of the hook plate by investigating the stress-strain state of the acromioclavicular joint in case of damage to the acromioclavicular static ligament complex. Materials and methods. The experimental part is based on the study of finite element models of the supraclavicular joint in normal conditions, with damage to the acromioclavicular stabilizers, and with fixation of the acromial end of the clavicle with a hook plate. The clinical material is based on the analysis of the treatment outcomes in 36 patients who were diagnosed with combined damage to the lig. acromioclavicularе inferior and lig. acromioclaviculare superior and hook plate fixation. Results. When both ligaments of the complex are damaged, the hook plate allows you to reduce the stress level in the clavicle almost to the normal level, but the stress on the coracoid process remains at a fairly high level of 90.0 MPa. Also, significant stresses occur on the acromion — 55.3 MPa and on the edge of the scapular notch — 54.2 MPa. At the same time, the stresses in the plate itself increase to 433.3 MPa, which is quite close to the strength limit of the material from which it is made. Conclusions. When both ligaments of the acromioclavicular complex are damaged, the hook plate allows you to reduce the level of stress in the clavicle almost to the normal level, but the stress on the coracoid process remains at a fairly high level. Also, significant stresses occur at the acromial process and along the edge of the scapular notch, which explains the development of erosions and, accordingly, subacromial conflict, which negatively affects treatment outcomes.

BackgroundThe shoulder joint has consistently drawn the interest of radiologists, physiologists, and orthopaedic surgeons. The precise measurements and geometry of the scapula are crucial to understanding shoulder pathomechanics. It is necessary to understand typical variations in the glenoid, coracoid, and acromion to maximize shoulder procedures’ success. This study reports the morphological characteristics and anthropometric measurements of the scapular bone structures in a representative sample of our community.MethodsA total of 60 dry human scapulae were studied. Morphological variations in the suprascapular notch, acromion, and glenoid cavity were observed. The dimensions of the scapular body, glenoid cavity, and coracoid and acromion processes were measured.ResultsWhen comparing the three-dimensional computed tomography (3D-CT) and sliding vernier calliper calibrations, no discernible variation was found in any of the measured parameters. The most prevalent morphologies were the oval-shaped glenoid, type II acromion, and type III suprascapular notch, corresponding to incidences of 50%, 70%, and 35%, respectively. The mean glenoid index among the determined parameters was 70% ± 1%. The average acromial thickness was 7.6 ± 1.4 mm, and the average coracoid tip-infer glenoid tubercle distance was 35 ± 5 mm.ConclusionsThe scapular bony components exhibit significant interpopulation variation in their morphological and anthropometric parameters. 3D-CT scans and direct measurements yielded closely aligned results, confirming the accuracy of CT for scapular evaluation. This highlights the usefulness of CT in different shoulder interventions. Preoperative planning to ascertain the scapular bony dimensions and knowledge of the morphology of scapular components is always advantageous.Trial registrationNot applicable for this study.

Introduction and importance: The acromion process of the scapula fractures is extremely rare, comprising only 3%–5% of all shoulder injuries and about 7%–8% of scapular fractures. Open reduction and internal fixation is indicated in significant displaced fracture, while for undisplaced fractures conservative treatment. Clinical presentation: A 47 year old African male, a mason with a history of injury to his right shoulder 1 hour prior to admission, after being hit on this right shoulder by a heavy metal from a breaking wall at his worksite, he reported the pain to be sharp with inability to use his right upper limb and no any other associated injuries. Psychosocial and past medical history was unremarkable. On examination the right shoulder was swollen, with ecchymosis, tender on palpation and on both passive and active movements, crepitus and neurovascular status of his right limb was intact. His laboratory workup including FBP, with Hb-14, blood group O+ and electrolytes were normal. His right shoulder plain radiography revealed an isolated displaced fracture of the acromion process, Type III according to Kuhn’s classification. He was treated surgically with open reduction and internal fixation with tension band wires, and the limb was splinted with an arm pouch/arm support. Post-operative period was uneventful. Control right shoulder x-ray was done, with acceptable fixation and he was instructed to start physiotherapy after 6 weeks. Three months of follow-up he was able to perform shoulder movements without pain, and after 6 months the fracture site had heal and he had returned to his activities. Discussion: Isolated fractures of the acromion process from a direct trauma are rare, usually they are treated conservatively, but for displaced fractures early surgical fixation should be considered. Conclusion: Isolated acromion process fractures that are displaced should be treated early and surgically, so as to avoid chances for non-union of the fractured fragments, and to restore shoulder function for a better quality of life.

Renal cell carcinoma (RCC) accounts for the majority of primary renal malignancies and frequently metastasizes to the lungs, liver, brain, and bones. However, initial presentation with an acromion process scapular lesion is extremely rare. We report a 52-year-old male with progressive pain and swelling over the right shoulder for 6 months. Imaging revealed an expansile lytic lesion in the scapular spine and acromion. Histopathology and immunohistochemistry confirmed metastatic clear-cell RCC. Positron emission tomography/computed tomography identified a large left renal mass with tumor thrombus in the renal vein and inferior vena cava, pulmonary nodules, and scapular lesion. The patient was treated with systemic therapy and planned local radiotherapy. This case underscores the importance of considering metastatic carcinoma in the differential diagnosis of destructive bone lesions, even when solitary, and highlights the role of histology and advanced imaging in establishing diagnosis and guiding multidisciplinary management.

The acromial opening angle is the angle whose apex corresponds to the angulus acromialis, formed by the junction between the spine of the scapula and the lateral edge of the acromial process. There are 3 different morphologies: C-shaped, L-shaped and with a "double angle". We hypothesis that the distribution of the acromial opening angle in a population was Gaussian and was not influenced by the shape of the angulus acromialis. Based on 103 dry cadaveric scapulas were determined the angle AÔB as: The crossing point between the spine of the scapula and the medial edge of the scapula (point A), The tip of the angulus acromialis (point O), the lateral edge of the acromion (point B). The shape of the angulus acromialis were noted. The series consisted of 62 (60%) left scapulas and 41 (40%) right scapulas. The shape of the angulus acromialis was: L shape: 47 (45.6%), C shape: 51 (49.5%), and double angle shape: 5 (4.8%). The average angulus acromialis was 105° (87.8°-124.9°; +/- 7.1°). The acromial opening angle as a function of the L, C and "double angle" shape was respectively 104.2° (87.8°-119.8°; +/- 7.3°), 105.7° (89.8°-124.9°; +/- 6.9°), 106.1° (98°-116.7°; +/- 8.6°). There was no significant difference in angulus acromialis as a function of side (p = 0.95) or acromion shape (p = 0.54). The average angulus acromialis is 104.9°. Variations in this angle modify the lateral offset of the acromion on plain radiographs, while the width of the acromion remains unchanged. It also modifies the posterior portal for shoulder arthroscopy.

Background: The narrowing of the subacromial space, which is the space right below the acromion process and above the shoulder joint, is known as subacromial impingement syndrome. Subacromial impingement syndrome (SAIS) describes the irritation and inflammation of the rotator cuff tendons as they go through the subacromial region, which causes pain, weakness, and a reduction in the shoulder’s range of motion. In the general population, shoulder pain (SP) is the third most prevalent musculoskeletal disease. Aim:This study aims to compare the dry needling for subacromial impingement effects on shoulder function and joint mobility Materials and method: A total of 20 subjects were selected and divided into two groups. Dry-needling technique group (n=10) and conventional physiotherapy with strengthening exercises group (n=10).SPADI scale and gonimeter was used to evaluate the functional activity and range of motion . Both intervention were given for 2 weeks, 5 session per week Results: The values were analyzed using the paired and unpaired t-tests.In both groups, the pre- and post-test results were analyzed using Goniometer and SPADI SCALE. With a p value of less than 0.0001, it was discovered that the dry-needling group’s mean value was more significant than that of traditional physiotherapy. Conclusion: This study indicates that conventional physiotherapy and a dry needling technique group are useful interventions for treating subacromial impingement syndrome. The study’s findings indicate that, when it comes to functional activity and range of motion, dry needling is a more effective treatment method for subacromial impingement syndrome subjects than conventional physiotherapy.

The present study was conducted from March, 2023–July, 2024, at the College of Veterinary Science, Proddatur, Andhra Pradesh, India. The scapula bones were collected using the maceration technique to record the gross and morphometrical features. The gross morphological study on the scapula of the Indian fox revealed that it was a triangular bone with two surfaces, three borders, and three angles. The cranial border was thin, convex and showed an anteriorly projected process. The caudal border was thick and straight. The dorsal border was convex. The scapular spine was well developed, increasing in height from above downwards, and it terminated in the acromion process. The maximum length of the right and left scapulae in Indian foxes were 6.0 cm and 5.93 cm respectively. The average maximum width of the right and left scapulae was 3.55 cm. The length of the scapular spine was 5.8 cm. The acromion process consisted of hamate and suprahamate processes. The hamate process was quadrilateral with the blunt end and over-hanged the glenoid notch. The supra-hamate process was triangular and directed caudally. The ratio of supra and infraspinous fossae was approximately 1:1. The subscapular fossa was along the attached border of the spine on the costal surface. The costal surface presented three ridges and the nutrient foramen was observed near the scapular neck. The tuber scapula was not well defined but had a coracoid process towards its costal surface. The glenoid cavity was shallow and oval. The average length and the width of the glenoid cavity were 1.28cm and 0.80 cm respectively.

Introduction The most common cause for separation of the acromioclavicular (AC) joint is from a direct force to the shoulder. Injury to the ligaments that surround and stabilize the AC joint leads to shoulder separation with displacement of the acromion and coracoid process with respect to the clavicle. Numerous surgical techniques have been described, but complications are still common with loss of reduction and hardware failure as the most common reasons for decreased patient satisfaction and need for revision. We describe our initial results of an AC joint reconstruction technique with subacromial hook plate fixation combined with a bioinductive collagen structural scaffold which allows for a stable and anatomic restoration of the AC joint. Case Report Patient is a 52 male who presented after a traumatic injury to the right shoulder with a symptomatic chronic grade 5 AC separation. After failed conservative care, he was treated with reconstruction of the AC coracoclavicular (CC) ligaments with the BioBrace® (CONMED Corporation, Largo, FL) bioinductive implant and a hook plate. The patient returned 3 months later for planned hook plate removal and was followed for 7 months postoperatively. Conclusion A combination technique utilizing hook plate fixation augmented with a bioinductive collagen implant was successfully used to treat a chronic AC separation. Histologic analysis of the harvested BioBrace® tissue at the time of hook plate removal at 3 months from index procedure demonstrates ideal and favorable host tissue incorporation with neocollagen tissue and remodeling of the BioBrace® implant. This is the first reported histologic analysis of BioBrace® following human implantation.

Background. There are two main methods to fix the acromial end of the clavicle with the help of metal structures: a hook plate, and the Weber’s method. Each of them has advantages and disadvantages. When using the Weber’s method, they are a violation of the integrity of the wire and spikes, destruction of the acromion process and the acromial end of the clavicle, migration of the spikes. When using a hook plate, this is a pain in the shoulder, destruction of bone tissue in the area of the acromion process, and subacromial conflict. Purpose: to conduct a comparative analysis of the fixation of the acromial end of the clavicle according to Weber, with hook plate and the proposed construction by studying the stress-strain state of the suprahumeral-clavicular joint with a combined injury of the lig.conoideum and lig.trapezoideum and various methods of fixation. Materials and ­methods. The finite element model of the suprahumeral-clavicular joint was built, which consisted of the scapula, clavicle, and ligaments of the suprahumeral-clavicular and coracoclavicular complexes. A combined injury of the ligaments of the suprahumeral-clavicular joint was modeled, namely lig.conoideum and lig.trapezoideum, with three methods of fixation: according to the Weber, hook plate and the proposed construction. Results. It was found that all types of fixators allow obtaining approximately the same level of stress in the bone elements of the model. An exception is Weber’s fixation, in which the stress on the acromial end of the clavicle and on the acromion process increases several times and even exceeds the strength limit of the cortical bone, which can be the cause of bone tissue destruction. The stresses in the wire itself can even exceed the strength limit of surgical steel and cause its break. A hook plate does not provide a sufficient stress reduction in the intact ligaments of the acromial-clavicular joint. The stress on the plate itself can approach the strength limit of surgical steel, which can cause its damage. The hinge-type fixator provides the best stress distribution, both in the bone elements of the model, and a fairly low level of stress in the intact ligaments. According to the criterion of minimizing the amount of relative deformations in the ligaments of the clavicle-scapular joint, the best results were shown by the hinge-type fixator. The largest relative deformations in the ligaments occur during fixation with a hook plate. Conclusions. Fixation of the acromial end of the clavicle according to Weber does not ensure its reliable fixation. The level of stresses in the wire during abduction of the limb approaches the strength limit of surgical steel, and stresses in the intact ligaments may even exceed the strength limit of cortical bone. All this can be the cause of complications such as breaking of the wire and destruction of bone tissue in the place of contact with it. The hook plate fixator does not provide sufficient stress reduction in the intact ligaments of the acromial-clavicular joint. The stresses on the plate itself can approach the strength limit of surgical steel, which can cause its damage. The fixator of the proposed design provides the best balance, in terms of both stress distribution in the model elements and the magnitude of relative deformations in the intact connections.

Evaluation of two scoring systems assessing the epiphyseal union at shoulder joint as predictors of chronological age among a sample of Egyptians

Purpose: The aim of this study was to investigate the effects of two strength training protocols, equated in volume, on the elbow flexor muscle thickness (MT) in women. Methods: Twenty-seven women (mean±sd, age 21.89±2.85 years; stature,167.82±5.90 cm; body mass 63.01±7.20 kg; estimate of body fat mass, 19.19±2.88%) were divided in three experimental groups: a drop-set (DS), a traditional (TR), and a control group (CG). The CG maintained regular strength training without perform any upper body exercises. The DS group performed a dumbbell biceps curl for two days/week, 12 weeks, 4 sets of 3 blocks of 10 repetitions at 75%, 55%, and 35% of their 1 Repetition Maximum (RM), and 8 sets of 11 repetitions at 75% of the 1RM for the TR protocol. Rest interval between sets was 120 seconds. The MT was acquired in the anterior face of both upper arms at 50% and 60% of the distance between the lateral epicondyle of the humerus and the acromial process of the scapula before (T0) and after the 24 training sessions (T1). Results: There was a significant increase in all MT measurements between T0 and T1for the training groups(p&lt;0.05). In addition, significantly higher values of MT were found in the training groups compared to the control group for all local measurements in T1 (p&lt;0.05). No significant differences were found between training the groups for MT. Conclusion: It appears that both training groups (DS and TR), were effective in promoting MT of the elbow flexors muscles of young women with no differences between training strategies. Keywords: Hypertrophy, Ultrasonography, Training method, Female

Background: Postoperative pain management is crucial to patient care and recovery after surgery. Effective pain control not only alleviates suffering but also facilitates quicker recovery, reducing the risk of complications such as chronic pain syndromes. By identifying ethnic differences in pain perception, healthcare providers can tailor their pain management strategies better to meet the needs of patients from diverse cultural backgrounds. This study therefore sought to determine and compare baseline and serial postoperative pain scores using a visual analogue scale among non-indigenous (Fulani, Hausa, Igbo, and Yoruba) and Indigenous ethnic groups (Berom, Tarok, Ngas, and Mwagavul) in Plateau State, Nigeria. Materials and Methods: This was a comparative cross-sectional study conducted among 88 adults of Indigenous and non-indigenous ethnic groups of Plateau State at the Jos University Teaching Hospital (JUTH) recruited through stratified random sampling. The equal proportion allocation technique was employed for gender and ethnic groups. Ethical clearance, informed verbal and written consent were obtained before the commencement of the study. Baseline pain scores were determined by a pressure algometer. A pressure of 20N was applied bilaterally on the trapezius muscle between the C7 spinous process and the acromial process, and then the subjects were asked to rate the pain they felt on a numeric rating scale (NRS). The average NRS score was taken as the baseline pain score. Serial 2-hourly postoperative pain scores were also assessed in the immediate 24-hour postoperative period. All analyses were conducted using Statistical Package for Social Sciences version 23 (SPSS Inc., Chicago, IL, USA). Significance was set at the α = 0.05 level. Results: A total of 88 patients participated in this study with an equal number of gender and ethnic group representation. The median (IQR) age of study participants was 21 (19.2–35.6) years. No significant statistical difference in median baseline pain scores between the entire indigenous (21.5) and non-indigenous (21.0) ethnic groups, U = 0.64, p = 0.22. There was a statistically significant difference in baseline median pain scores between females (3.5) and males (2.0), U = 3.0, p = 0.036 in the indigenous and females (3.0) and males (2.0) in the non-indigenous ethnic groups, U = 3.9, p = 0.013. This study revealed a statistically significant difference in the median serial postoperative pain scores in the different specific Indigenous ethnic groups (H (2) = 24.2, p = 0.001) and the different specific non-indigenous ethnic groups (H (2) = 24.8, p = 0.001) as well. Conclusion: This study has demonstrated ethnic and gender variability in the perception of pressure and postoperative pain among different ethnic groups resident in Plateau State. Clinicians need to be aware of the fact that different ethnic groups in Plateau State perceive pain differently and put it into consideration when treating pain.

Scapular stress fracture (SSF) after reverse total shoulder arthroplasty is a unique and common complication that may have negative impact for long-term outcomes. Scapular stress reaction (SSR), characterized by pain and tenderness without radiographic evidence of fracture, can be precursor of SSF. We believe that early detection using SPECT/CT with proper management for SSRs including acromion, scapular spine, and coracoid process is crucial for better prognosis without additional complications by preventing SSFs. Therefore, we present 3 typical cases with SSR following reverse total shoulder arthroplasty with the findings of SPECT/CT.

Osteology and relationships of the Late Triassic giant dicynodont <i>Lisowicia</i>

Introduction Endovascular surgery is an innovative way of carrying out procedures such as transcatheter aortic valve insertion where the femoral artery is commonly used as an access point. Conditions like peripheral arterial disease can make endovascular procedureschallenging when atherosclerotic plaques compromise the integrity of lower limb vessels. An alternativeaccess point for these patients isrequired. Access through the axillary artery has been proposed; however, the close proximity of the brachial plexus introduces a risk of neural complications. This study aims to find an anatomical or bony landmark(s) to help identify an area of safety on the axillary artery that can be used to gain access. Materials and methods Nine cadavers were used in the study and five parameters were measured using the acromion and coracoid processes as bony landmarks. The 1st parameter measured the distance between the acromion and the coracoid process. The 2nd parameter was the diameter of the axillary artery taken at a plane extending from the acromion to the coracoid process - now defined as the coracoacromial plane. The 3rd measurement was the distance between the coracoid process and the midpoint of the axillary artery diameter taken at the above plane; it is proposed this will form a safe point on the axillary artery. The 4th parameter measured was the distance between the safe point on the axillary artery and the median nerve. The 5th parameter was the distance between the safe point and the thoracoacromial trunk. Measurements were taken using digital callipers and were recorded for both sides of the cadaver except for one. Using the data from the measurements, an area of safety was calculated and statistical analysis was carried out using Student's t-test and Pearson's correlation to look for significant differences between the left and right sides. Results The mean distance from the safe point of the axillary artery to the median nerve was 23.25 mm on the left and 27.10 mm on the right. The p-value was 0.7, which indicated no significant differences between both sides. The mean distance between the safe point and the thoracoacromial trunk was 11.31 mm on the left and 13.21 mm on the right. The p-value was 0.24, indicating no significant differences between both sides. The mean area of safety was larger on the right side with an area of 184.37 mm and smaller on the left side with an area of 158.93 mm. The p-value was 0.62, which indicated no significant differences between both sides. There was no clear relationship between the distance from the acromion to the coracoid process compared to the distance between the acromion and a defined safe point on the axillary artery. This was confirmed using a Pearson's correlation test, which resulted in a p-value of 0.53 on the left and 0.93 on the right. These values were above the critical value, suggesting no correlation. Conclusion The acromion and the coracoid process are important bony landmarks that can be used to define the coracoacromial plane that traverses the axillary artery whereby avoiding the cords of the brachial plexus, the median nerve as well as the thoracoacromial trunk. Implementing this approach to define a safe vascular access point on the axillary artery could minimise complications like brachial plexus injuries. Further studies on a larger sample size using radiological methods may need to be carried out to help increase confidence in these preliminary cadaveric findings.

Background. There are two main methods of fixing the acromial end of the clavicle with the help of metal structures: hook plate, and Weber’s technique (tension band wiring). The disadvantages of modern fixing structures negatively affect treatment outcomes, which requires the development of advanced methods to stabilize the acromial end of the clavicle. Purpose: to conduct a comparative analysis on the fixation of the acromial end of the clavicle according to Weber, using hook plate and the proposed construction by studying the stress-strain state of the suprahumeral-clavicular joint with a combined injury of the lig.acromioclaviculare inferior and lig.acromioclaviculare superior and various methods of fixation. Materials and methods. In this study, we modeled a combined injury of the ligaments of the suprahumeral-clavicular joint, namely lig.acromioclaviculare inferior and lig.acromioclaviculare superior, with fixation of the acromial end of the clavicle in three ways: according to Weber, with hook plate and the proposed construction. We used loads that act on the suprahumeral-clavicular joint when the upper extremity is abducted to an angle of 90°. Results. It was found that all types of fixators in case of damage to the lig.acromioclaviculare inferior and lig.acromioclaviculare superior allow to obtain approximately the same level of stress in the bone elements of the model. An exception is Weber’s fixation, in which the stress on the acromial end of the clavicle and on the acromion process increases several times, which can be the cause for the destruction of bone tissue in the area of contact with metal elements. The stresses in the wire itself can even exceed the strength limit of surgical steel and, as a result, cause it to break. The hinge-type fixator provides the best stress distribution, both in the bone elements of the model, and a fairly low level of stress in the intact ligaments. Hook plate, from the point of view of stress values in the elements of the model, has good indicators for isolated ligament injuries and occupies an intermediate position according to all the studied indicators. In term of the criterion of minimizing relative deformations in the ligaments of the clavicular-scapular joint in case of damage to the lig.acromioclaviculare inferior and lig.acromioclaviculare superior, the Weber fixation method showed the best outcomes. But the results of the study on stress distribution in this model negate the advantages of minimizing the deformations of the intact ligaments. Conclusions. Fixation of the acromial end of the clavicle according to Weber provides good results in terms of reducing the level of stresses and relative deformations in the intact ligaments, but leads to a severalfold increase in the level of stresses on the acromial end of the clavicle and the acromion process. The level of stresses in the wire during abduction of the limb in case of damage to the ligaments of the clavicular-acromial joint may exceed the strength limit, which may be the cause of wire breaking and, as a result, loss of stability of the suprahumeral-clavicular joint. The hook plate occupies an intermediate position in terms of stress distribution in the model, but according to the index of relative deformations in the intact ligaments, it showed the worst result. Fixator of the proposed design provides the best balance, both according to the criterion of stress distribution in the model elements and the magnitude of relative deformations in the intact ligaments.