A Novel Fluoroscopic View for Positioning the AO Clavicle Hook Plate Decreases Its Associated in situ Complications

Hyun, Yoon Suk; Kim, Gab-Lae; Choi, Sang Min; Shin, Woo Jin; Seo, Dong Yeon

doi:10.5397/cise.2016.19.1.25

Cited by 3 publications

(10 citation statements)

References 28 publications

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“…Subacromial osteolysis and rotator cuff injury caused by the hook are serious complications caused by clavicle hook plates, and there are many reports of these complications [1][2][3][4][5][6][7][8][9][10][11]. An inappropriate hook depth and incongruency between the hook and undersurface of the acromion have been reported as causes of subacromial osteolysis [20][21][22][23].…”

Section: Discussionmentioning

confidence: 99%

“…It is necessary to determine the appropriate hook bending angle for each patient. Hyun et al reported that subacromial osteolysis can be reduced by bending the hook using a fluoroscopic view obtained by directing the X-ray beam from the anterior to posterior direction at approximately 30 to 40 degrees caudally [4]. However, Lee et al reported that arthroscopy is necessary because fluoroscopic assessments cannot be used to accurately evaluate the presence of impingement of the hook and the rotator cuff [2].…”

Section: Discussionmentioning

confidence: 99%

“…In previous reports, X-ray or computed tomography (CT) was commonly used to evaluate subacromial osteolysis [2,4,[6][7][8][9][10]. However, it is difficult to accurately evaluate subacromial osteolysis.…”

Section: Discussionmentioning

confidence: 99%

“…Clavicle hook plates used for the treatment of distal clavicle fractures provide strong fixation, and the surgical procedure is relatively easy to perform. However, complications such as subacromial osteolysis and rotator cuff injury due to the hook have been reported [1][2][3][4][5][6][7][8][9][10][11]. The hook portion of the clavicle hook plate is placed under the acromion, and downward pressure is applied from the plate 3 portion on the clavicle to reduce the fracture.…”

Section: Introductionmentioning

confidence: 99%

“…The hook portion of the clavicle hook plate is placed under the acromion, and downward pressure is applied from the plate 3 portion on the clavicle to reduce the fracture. Pressure is continuously applied to the undersurface of the acromion after the operation to suppress the upward dislocation of the distal end of the clavicle, and this pressure has been shown to cause subacromial osteolysis [2][3][4][6][7][8][9][10]. If the severity of subacromial osteolysis progresses significantly, a serious complication, acromial fracture, occurs [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

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Reduction of subacromial osteolysis by bending the hook arthroscopically in clavicle hook plate fixation for distal clavicle fractures

Okazaki¹,

Shiba²,

Takeuchi³

et al. 2020

Preprint

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Background: Subacromial osteolysis is a serious complication caused by clavicle hook plates. Incongruency between the hook and undersurface of the acromion has been reported as a cause of subacromial osteolysis. The aim of this study was to retrospectively examine the effectiveness of hook bending in reducing subacromial osteolysis. Methods: Twenty-two patients with unstable distal clavicle fractures were treated with clavicle hook plates. There were 19 males and 3 females, with a mean age of 55.0 years. They were followed for a mean period of 9.5 months. The patients were divided into two groups; there were 10 patients whose hook was bent (the bending group) and 12 patients whose hook was not bent (the nonbending group). In the bending group, the hook was bent using a dedicated bender such that the hook and the undersurface of the acromion were parallel, and the direction of the hook was confirmed arthroscopically. At plate removal, arthroscopy was performed in both groups to observe the subacromial bony defect and the rotator cuff injury. Results: One patient in the nonbending group had a fibrous union, but bone union was achieved in all other patients. In the bending group, the angle at which the hook was inclined downward with respect to the distal portion of the plate (hook inclination angle) was 9.3 ± 6.1˚ (range, 2-23˚). The subacromial bony defects were significantly smaller in the bending group (1.7 ± 2.4 mm) than in the nonbending group (4.7 ± 2.3 mm) (P<0.05). Partial-thickness rotator cuff tears localized around the hook were observed arthroscopically in 6 patients in the bending group (60%) and in 7 patients in the nonbending group (58%). Conclusions: When the hook was bent such that it was parallel to the undersurface of the acromion, the degree of subacromial osteolysis was reduced.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Reduction of subacromial osteolysis by bending the hook arthroscopically in clavicle hook plate fixation for distal clavicle fractures

Okazaki¹,

Shiba²,

Takeuchi³

et al. 2020

Preprint

View full text Add to dashboard Cite

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Complications and Frequency of Surgical Treatment with AO-Type Hook Plate in Shoulder Trauma: A Retrospective Study

Lee

Eom

Hyun

2022

JCM

Self Cite

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We investigated the complications and frequency of hook plate fixation in patients with shoulder trauma. We reviewed 216 cases of hook plate fixation use at our hospital between January 2010 and May 2020. Finally, we included 76 cases of acute distal clavicle fracture (DCF) and 84 cases of acute acromioclavicular joint dislocation (ACD). We investigated all complications after hook plate use, bony union in the DCF group, and reduction loss in the ACD group. We defined painful shoulder stiffness (PSS) as aggravating resting pain with stiff shoulder, and pain on shoulder elevation (PSE) as continued shoulder pain on elevation without PSS before plate removal. PSS was managed with intra-articular steroid injections or manipulation with or without arthroscopic capsular release (ACR). PSS occurred in 36 and 33 cases of DCF and ACD, respectively. PSE occurred in 17 of 76 fractures and 13 of 84 dislocations. However, no iatrogenic rotator cuff injury was verified by magnetic resonance imaging in patients with PSS or PSE. Subacromial erosion in patients with hook plate fixation should be considered a sequela and not a complication because it is unavoidable in surgery with an AO-type hook plate. The most common complication was PSS, followed by PSE.

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Is Bending the Hook Plate Necessary in Acromioclavicular Joint Dislocation?

Jung

2021

Clin Shoulder Elbow

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A Novel Fluoroscopic View for Positioning the AO Clavicle Hook Plate Decreases Its Associated in situ Complications

Cited by 3 publications

References 28 publications

Reduction of subacromial osteolysis by bending the hook arthroscopically in clavicle hook plate fixation for distal clavicle fractures

Reduction of subacromial osteolysis by bending the hook arthroscopically in clavicle hook plate fixation for distal clavicle fractures

Complications and Frequency of Surgical Treatment with AO-Type Hook Plate in Shoulder Trauma: A Retrospective Study

Is Bending the Hook Plate Necessary in Acromioclavicular Joint Dislocation?

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