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Treatment of Tossy III acromioclavicular joint injuries using hook plates and ligament suture
Khaled Hamed Salem1, Andreas Schmelz
1Department of Trauma, Hand, Plastic and Reconstructive Surgery, University of Ulm, Ulm, Germany. khaled_hamedsalem@hotmail.com
Objectives:
The management of acromioclavicular (AC) injuries has long been debated. We analyzed our results in treating such cases using hook plates and ligament suture.
Design:
: Retrospective nonrandomized study.
Setting:
Level I Trauma Center (University Hospital).
Patients:
Twenty-five patients (mean age 41 years) with complete Tossy III AC joint disruptions. Using the Rockwood classification, 15 dislocations were classified as type V injuries, 9 as type III injuries, and 1 as a type IV injury.
Intervention:
All patients were operatively treated using AC hook plates with ligament suturing after a median delay of 7 days.
Main Outcome Measures:
Clinical and radiographic evaluation using Constant-Murley functional score and Taft et al criteria.
Results:
: A retrospective clinical and radiographic evaluation of 23 patients was performed after an average follow-up period of 30 months. The mean Constant score was 97 (range, 90-100) points, and the mean Taft score was 10.6 points. All but 1 patient were satisfied with their treatment outcome. Eight cases showed some loss of reduction after plate removal. A poor correlation existed, however, between clinical and radiographic results.
Conclusions:
The hook plate is a reliable fixation tool for complete AC joint dislocations, ensuring immediate stability and allowing early mobilization with good functional and cosmetic results. Routine plate removal should however be reevaluated.
