Surgical Treatment of Acromioclavicular Dislocation: Hook Plate Versus Suture Button

Abstract

Objectives: We aimed to compare the functional and radiographical outcomes of reconstruction of acute unstable acromioclavicular joint (ACJ) dislocation using Hook Plate (HP) versus Suture Endobutton (SE) fixation techniques. Methods: Forty-six consecutive patients with grade III to V ACJ dislocation according to Rockwood classification who underwent either HP or SE fixation in the period between January 2017 and June 2020 were evaluated. The treatment modalities were divided into either HP or SE fixation. The radiological assessment included standard anterior-posterior (AP) views to evaluate coracoclavicular (CC) distances for vertical reduction. Results: CC distances were grouped as preoperative (CC1), early postoperative (CC2), and late postoperative (CC3). The distance variance between CC2 and CC3 was referred as ΔCC (CC3 - CC2). A statistically significant difference was found in ΔCC between the two groups (p=0.008). ΔCC was significantly higher in the SE group compared to the HP group (p<0.05). The Constant and UCLA Scores of patients in the SE group were found to be significantly higher than in the HP group patients. Conclusion: Clinical outcomes were more satisfactory in patients with acute unstable ACJ dislocation who underwent SE compared to HP procedures, at the end of the first year. Evidence Level IV; Case Series.

Comparison of Surgical Techniques Used in Treating Acromioclavicular Dislocation in Patients Participating in Sports: A Systematic Review

“…Liu et al described similar results in a study that evaluated the clinical and radiological outcomes of patients with AC displacement treated with the clavicular hook plate, who had an increase in the Constant-Murley score from 72.6 before surgery to 87.6 at final follow-up [18]. Another group of patients treated with the same technique had a mean score of 94.59 points in a study published by Dursun et al [19]. In addition, 24 patients evaluated by this review that underwent arthroscopy showed an increase from 61 to 87 points on this scale 1 year after surgery [12].…”

“…As an example, this technique achieved satisfactory and functional postoperative and evolutionary results, and increased evaluation scores and lower intra and postoperative complications compared to the other methods studied (arthroscopy, single tunnel, and coracoid sling). How-ever, references indicate that other techniques, such as the suture button, are preferable to the titanium plate in terms of CC distance and clinical outcome, despite the fact that scores and pain relief are the same [19] [23].…”