Clavicle Hook Plate Research Articles

Clavicle Hook Plate를 이용한 견봉 쇄골 관절 손상의 치료

Purpose: To analyze results of treating acromioclavicular injuries using clavicle hook plates. Materials and Methods: Between February 2008 and April 2010, 18 patients with acromioclavicular joint injury treated by clavicle hook plates were reviewed. Using the Rockwood classification, 7 dislocations were classified as type III injuries and 11 as type V injuries. Implant removal was done at least 3 months from initial fixation. Simple X-rays were taken for comparing the state of reduction, and clinical outcomes were evaluated by the Korean Shoulder Scoring System and the American Shoulder Elbow Society score. The average follow-up period was 9 months. Results: On weight bearing X-rays, the average coracoclavicular distance showed a 114% increase compared to the contralateral side at the time of injury. It decreased to 23% by the last follow-up. The mean Korean Shoulder Scoring System and the American Shoulder Elbow Society score were 80 and 74 at the last follow-up. Conclusion: The immediate stability these plates provide allows rapid rehabilitation. Clavicle hook plate fixation for acromioclavicular joint dislocation is considered an effective method for ensuring satisfactory results both radiologically and clinically.

鎖骨遠位端骨折に対するBest肩鎖関節プレートとClavicle hook plateの治療成績

鎖骨遠位端骨折に対するBest肩鎖関節プレートとClavicle hook plateの治療成績

A discussion of acromial cleft following fixation with clavicle hook plate

肩锁关节脱位的手术治疗方法较多,锁骨钩钢板固定是近年来应用较多的新技术.但随着该项技术的应用,逐渐出现多种并发症的报道~([1]),尤其是肩部不明原因的疼痛、近端钉部的应力骨折和取钉后仍有一定的复发率。

Subacromial morphometric assessment of the clavicle hook plate

Background Clavicle hook plates are an effective plate fixation alternative for distal clavicle fractures and severe acromioclavicular joint dislocations. However, post-operative complications associated with the subacromial portion of the hook include acromial osteolysis and subacromial impingement. We examine and quantify the three-dimensional position of the subacromial portion of the hook plate relative to surrounding acromial and subacromial structures in a series of cadaveric shoulders to determine if hook positioning predisposes the shoulder to these noted post-operative complications. Materials and methods Fifteen cadaveric shoulders (seven males, eight females) were implanted with 15- or 18-mm hook plates. Dimensions of the acromion and hook plate were digitised and reconstructed into a three-dimensional model to measure acromion dimensions and distances of the subacromial hook relative to surrounding acromial and subacromial structures. Results Inter-specimen dimensions of the acromion were highly variable. Mean acromion width and thickness were greater in males than in females ( p = 0.01). The posterior orientation of the subacromial hook varied widely (mean posterior implantation angle = 32.5 ± 20°, range 0–67°). The hook pierced the subacromial bursa in 13/15 specimens, made contact with the belly of the supraspinatus muscle in 9/15 specimens, and had focal contact at the hook tip with the undersurface of the acromion in 9/15 specimens. Conclusions The wide range of acromial dimensions leads to a high degree of variability in the positioning of the subacromial hook. The observed frequency of hook contact with surrounding subacromial structures in a static shoulder confirms that the position of the hook portion of the implant can predispose anatomic structures to the post-operative complications of subacromial impingement and bony erosion.

The Clavicle Hook Plate for Neer Type II Lateral Clavicle Fractures

To evaluate functional and radiologic outcome in patients with a Neer type II lateral clavicle fracture treated with the clavicle hook plate. Multicenter retrospective study. Five level I and II trauma centers. Forty-four patients, average age 38.4 years (18-66 years), with a Neer type II lateral clavicle fracture treated with the clavicle hook plate between January 1, 2003, and December 31, 2006. Open reduction and internal fixation with the clavicle hook plate. Removal of all 44 implants after consolidation at a mean of 8.4 months (2-33 months) postoperatively. At an average follow-up of 27.4 months (13-48 months), functional outcome was assessed with the Constant-Murley scoring system. Radiographs were taken to evaluate consolidation and to determine the distance between the coracoid process and the clavicle. The average Constant score was 92.4 (74-100). The average distance between the coracoid process and the clavicle was 9.8 mm (7.3-14.8 mm) compared with 9.4 mm (6.9-14.3 mm) on the contralateral nonoperative side. We observed 1 dislocation of an implant (2.2%), 2 cases of pseudarthrosis (4.5%), 2 superficial wound infections (4.5%), 2 patients with hypertrophic scar tissue (4.5%), and 3 times an acromial osteolysis (6.8%). Thirty patients (68%) reported discomfort due to the implant. These implant-related complaints and the acromial osteolysis disappeared after removal of the hook plate. With all the patients, direct functional aftercare was possible. The clavicle hook plate is a suitable implant for Neer type II clavicle fractures. The advantage of this osteosynthesis is the possibility of immediate functional aftercare. We observed a high percentage of discomfort due to the implant; therefore, we advise to remove the implant as soon as consolidation has taken place.

肩鎖関節脱臼に対する靭帯再建を行わない AO clavicle hook plate (CHP) の治療成績

肩鎖関節脱臼に対する靭帯再建を行わない AO clavicle hook plate (CHP) の治療成績

Treatment of unstable dislocation of sternoclavicular joint with clavicle hook plates

Objective To discuss the clinical treatment of unstable dislocation of the sternoclavicular joint with clavicle hook plates. Methods From April 2005 to October 2007, 19 cases of unstable dislo-cation of stemoclavicular joint were treated with open reduction and internal fixation by clavicle hook plates. There were 17 cases of Grade type Ⅲ and 2 cases of Grade type Ⅱ. After open reduction and internal fixation, all patients received arthroplasty and repair of eostoclavicular and sternoclavicular ligaments. Results None had intraoperative injury to nerves and blood vessels. Follow-ups from 6 to 24 (mean, 8) months showed 16 excellent cases, 2 good cases and 1 fair case by Roekwood criteria, the good to excellent rate being 94.7%. The healing duration lasted 3 to 6 (averaging 4) weeks. No infection, sliding or loosening of internal fixation, nonunion or re-dislocation was found postoperatively. Conclusion The clavicle hook plate is an effective and advanced surgical treatment of sternoclavieular joint injuries, because its easy and mini-invasive operation can provide sturdy fixation and lead to good functional recovery. Key words: Dislocation; Plate; Sternoclavicular joint

Acromioclavicular joint dislocation: a comparative biomechanical study of the palmaris-longus tendon graft reconstruction with other augmentative methods in cadaveric models

BackgroundAcromioclavicular injuries are common in sports medicine. Surgical intervention is generally advocated for chronic instability of Rockwood grade III and more severe injuries. Various methods of coracoclavicular ligament reconstruction and augmentation have been described. The objective of this study is to compare the biomechanical properties of a novel palmaris-longus tendon reconstruction with those of the native AC+CC ligaments, the modified Weaver-Dunn reconstruction, the ACJ capsuloligamentous complex repair, screw and clavicle hook plate augmentation.HypothesisThere is no difference, biomechanically, amongst the various reconstruction and augmentative methods.Study DesignControlled laboratory cadaveric study.Methods54 cadaveric native (acromioclavicular and coracoclavicular) ligaments were tested using the Instron machine. Superior loading was performed in the 6 groups: 1) in the intact states, 2) after modified Weaver-Dunn reconstruction (WD), 3) after modified Weaver-Dunn reconstruction with acromioclavicular joint capsuloligamentous repair (WD.ACJ), 4) after modified Weaver-Dunn reconstruction with clavicular hook plate augmentation (WD.CP) or 5) after modified Weaver-Dunn reconstruction with coracoclavicular screw augmentation (WD.BS) and 6) after modified Weaver-Dunn reconstruction with mersilene tape-palmaris-longus tendon graft reconstruction (WD. PLmt). Posterior-anterior (horizontal) loading was similarly performed in all groups, except groups 4 and 5. The respective failure loads, stiffnesses, displacements at failure and modes of failure were recorded. Data analysis was carried out using a one-way ANOVA, with Student's unpaired t-test for unpaired data (S-PLUS statistical package 2005).ResultsNative ligaments were the strongest and stiffest when compared to other modes of reconstruction and augmentation except coracoclavicular screw, in both posterior-anterior and superior directions (p < 0.005).WD.ACJ provided additional posterior-anterior (P = 0. 039) but not superior (p = 0.250) stability when compared to WD alone.WD+PLmt, in loads and stiffness at failure superiorly, was similar to WD+CP (p = 0.066). WD+PLmt, in loads and stiffness at failure postero-anteriorly, was similar to WD+ACJ (p = 0.084).Superiorly, WD+CP had similar strength as WD+BS (p = 0.057), but it was less stiff (p < 0.005).Conclusions and Clinical RelevanceModified Weaver-Dunn procedure must always be supplemented with acromioclavicular capsuloligamentous repair to increase posterior-anterior stability. Palmaris-Longus tendon graft provides both additional superior and posterior-anterior stability when used for acromioclavicular capsuloligamentous reconstruction. It is a good alternative to clavicle hook plate in acromioclavicular dislocation.

Clavicle hook plate (SYNTHES^【○!R】) による鎖骨遠位端骨折の治療成績と問題点

Clavicle hook plate (SYNTHES^【○!R】) による鎖骨遠位端骨折の治療成績と問題点

Use of the AO hook-plate for treatment of unstable fractures of the distal clavicle

We used a new internal fixative implant, the AO clavicle hook-plate, for treatment of unstable fractures of the distal clavicle. This study describes the operative procedure and the clinical results obtained, as well as discussion of the advantages and problems encountered. Fifteen consecutive patients with unstable fractures of the distal clavicle (Neer type II) were treated using AO clavicle hook-plates. The average age of patients was 47 years and there were 13 males and 2 females. The mean follow-up period was 15.5 months. Plain radiographs of clavicles were used to assess bony union. Functional recovery of the shoulder joint was assessed using the Constant-Murley scoring system. All fractures eventually achieved solid bony union within 4 months after surgery. Thirteen patients (87%) showed hook migration into the acromion. Clinical results were excellent with a mean Constant-Murley score of 89 points at final follow-up. AO clavicle hook-plates are useful fixative implants for unstable fractures of the distal clavicle. Static fixation was achieved and physiotherapy can be started immediately after surgery. Early removal of the implant is recommended however because hooks inserted under the acromion migrated into the bone in most cases.

Experience with Best acromioclavicular plate and Clavicle hook plate for distal clavicular fracture

Experience with Best acromioclavicular plate and Clavicle hook plate for distal clavicular fracture

Treatment of Displaced Lateral Clavicle Fractures with the AO Hook Plate

A longitudinal retrospective analysis of 13 patients with displaced lateral clavicle fractures (Neer-Allman Group II Type II) treated with open reduction and internal fixation with the lateral clavicle hook plate (AO hook plate ‘SYNTHES’) is presented here. High union rates (12/13 patients) and excellent return to function are demonstrated. The operative technique is described and recommendations have been made. We also examine possible factors contributing to the one case of non-union.

Hook-plate fixation of unstable lateral clavicle fractures: A report on 63 patients

Background Hook-plate fixation of unstable lateral clavicle fractures has given promising results in previous reports, but numbers of patients have been small. We assessed the results of this technique in 63 patients.Patients and methods 63 patients with unstable lateral clavicle fractures were operated on at Oulu University Hospital during 1997–2004, using a clavicle hook-plate. Fracture union and complications were assessed retrospectively from case records and radiographs. The subjective part of the Constant score, Oxford shoulder questionnaire data and subjective shoulder value (SSV) were assessed after an average of 3.6 years in 58 patients. 31 patients were reviewed at the outpatient clinic, using complete Constant scores and radiographs of both acromioclavicular joints.Results 59 fractures united uneventfully. There was 1 case of delayed union and 3 nonunions, but only 1 of these required surgery. Additional complications involved 1 case of infection, 1 frozen shoulder and 3 cases of late fracture medial to the plate. The mean Oxford score was 15, the mean for the subjective part of the Constant score was 32, and the SSV was 86%.Interpretation Clavicle hook-plate fixation of unstable lateral clavicle fractures results in a good union rate and good shoulder function.

鎖骨遠位端骨折におけるClavicle hook plateの小経験

鎖骨遠位端骨折におけるClavicle hook plateの小経験

鎖骨遠位端骨折に対するclavicle hook plateの治療経験

鎖骨遠位端骨折に対するclavicle hook plateの治療経験

鎖骨遠位端骨折に対するＣｌａｖｉｃｌｅ Ｈｏｏｋ‐Ｐｌａｔｅによる治療経験

Seven cases of displaced fractures of the distal clavicle were treated using the clavicle hook-plate. They were classified into type II (six cases) and type II+III (one case) according to the Neer classification. All cases had bone union. In addition, all cases achieved more or less full range of motion at the shoulder joint.The clavicle hook-plate provides stable fixation for fractures of the distal clavicle even in the presence of communited small fragments.

クラビクルフックプレートの使用経験

The purpose of this study is to evaluate the results of surgical treatment using the clavicle hook plate. Between June 2003 and July 2004, nine patients (eight men and one woman), with a mean age of 45 years (20 to 60) were treated using this plate. Six had distal claviclar fracture (Neer type II) and three had AC dislocation. The patients were evaluated after a mean follow up of eight months (4 to 12) using the Japan Orthopaedic Association shoulder score. As the plate was not removed in six patients, we evaluated pain, function, and range of motion. The average JOA score was 77.2 points (65 to 80). Clinical results were satisfactory, but the hook of the plate was found to have migrated to the acromion in all patients on X-ray.