Functional outcome for the acromioclavicular joint disruption with or without lateral end clavicle fractures treated with hook plate

Abstract

BACKGROUND: Acromioclavicular (AC) joint dislocation is most frequently encountered in contact sports and is far more common in males. Grade‑III AC dislocation involves complete loss of contact between the clavicle and acromion secondary to the total disruption of both the AC and coracoclavicular ligaments, with loss of vertical and horizontal stability, respectively. The use of hook plate on open reduction and internal fixation of the AC joint dislocation had a little adverse effect on shoulder function and is an effective method for the treatment of AC joint dislocation. Hence, this retrospective study was carried out to assess the clinical and functional outcome of AC joint injuries treated with hook plate. AIM: The aim of this study is to assess and document the clinical and functional outcome of AC joint dislocation with or without lateral end clavicle fracture treated with hook plate. MATERIALS AND METHODS: This retrospective study of patients with Rockwood Type III AC joint disruption (dislocation) who were treated in our hospital. During the period from July 2013 to July 2018, a total of 33 patients with Type III AC joint disruption with or without associated lateral end clavicle fractures were included in this study, with 26 males and 7 females. The functional outcome was assessed using the CONSTANT scoring system during follow‑up after hook plate fixation at 4 weeks, 3 months, 6 months, and 12 months. RESULTS: Thirty three patients with AC joint disruption were participated in the study after meeting the inclusion and exclusion criteria. There were 26 males (78.8%) and 7 females (21.2%) with a mean age of 44.7 years, eight patients had an associated lateral end clavicle fracture. All the patients were fixed with hook plate were followed up for a period of 1 year postoperatively. The mean Constant score improved progressively from a preoperative score of 44.5 to postoperative score of 68.3 at 4 weeks, 77.9 at 3 months, 89.4 at 6 months, and 93.3 at 12 months. CONCLUSIONS: In the current study, we conclude that the surgical and functional outcomes after AC joint stabilization with or without lateral end clavicle fractures using hook plate fixation yield satisfactory results. The hook plate also provides good horizontal, rotational, and vertical stability. Furthermore, the maintenance of reduction by the hook plate was significantly superior compared to the other modes of treatment. The hook plate also facilitates early mobilization and prevents stiffness of the shoulder joint.