The stabilizing effect of various implants on the torn acromioclavicular joint

Abstract

A biomechanical in vitro test was performed to determine the stabilizing effect of various implants for the surgical treatment of the torn acromioclavicular joint. In a specially designed testing device, plastic and cadaver specimens of the shoulder girdle were stressed in various ways. Different dislocations between the acromion and the clavicle and between the clavicle and the coracoid were determined, as well as the stiffness of the implants. A convenient stabilizing effect combined with less rigid fixation to secure the newly treated AC joint was provided by K-wire fixation with cerclage. Interfering shear and bending stresses could be avoided with this method, while the other implants showed various disadvantages. From a biomechanical point of view, a carbon-fiber ligament replacement provides sufficient stability in cases of chronic acromioclavicular separation.

Surgical treatment of unstable fractures of the distal clavicle: A comparative study of Kirschner wire and clavicular hook plate fixation

“…We found no evidence that the plate damages the acromion or rotator cuff, although it is inserted into the subacromial space. Kiefer et al (1986) compared the mechanical strengths of various types of xation of the AC joint and found that transarticular K-wires with a tension band were much more stable than a clavicular hook plate (Balser plate), which had no rotational stiffness. During mobilization of the shoulder, rotation of the clavicle causes migration of wires.…”

“…When a clavicular hook plate is used, the AC joint can rotate normally and undisturbed boneto-bone healing occurs at the fracture site. Coracoclavicular screw xation is also a mechanically good method (Kiefer et al 1986), but it is dif cult to perform, especially if inexperienced, but good results have been reported (Ballmer andGerber 1991, Yamaguchi et al 1998).…”

Comparison of the efficacy of hook plate versus tension band wire in the treatment of unstable fractures of the distal clavicle

“…One of the popular surgical methods is trans-articular or extraarticular tension band wire fixation, but that involves considerable risks for complications, especially loss of reduction, pin migration, and skin ulceration due to pin irritation [5,[7][8][9]. If the distal fragment is small or comminuted, it is difficult to achieve stable fixation and early mobilisation.…”

Treatment of displaced lateral clavicular fractures with hook plate, a retrospective review

“…Regazonni [14] et al described double plating using mini AO plates with good results. Kaifer [15] described in detail the biomechanical stabilizing function of hook plate. Various publications have demonstrated good results of hook plate fixation [16,19] .…”