Analysis of hardware complications and functional outcomes following sternoclavicular hook plate fixation for
Li Sheng1, Youyou Zhu2, Yaqing Wu2
1Hangzhou Geriatrics Hospital (Hangzhou First People's Hospital Chengbei District), Hangzhou, Zhejiang, China.
Background:
This study evaluates the efficacy and complications associated with sternoclavicular (SC) hook plates in treating traumatic sternoclavicular joint (SCJ) dislocations.
Methods:
We retrospectively analyzed patients who underwent SC hook plate fixation for SCJ dislocations, focusing on hardware-related complications such as plate breakages and fixation failures. Clinical outcomes, functional recovery, and complications were assessed. Post-operative imaging, including X-rays and computed tomography scans, was used to evaluate joint reduction and hardware integrity. Functional outcomes were measured using the Constant Murley Shoulder Score and visual analog scale for pain.
Results:
Forty-six patients (mean age: 49.3 years; 44 males [95.7%]) were analyzed, with 14 patients (30.4%) categorized as having a high preinjury activity level (Tegner scale ≥6). The SC hook plates effectively stabilized the joint, as evidenced by a significant increase in the mean Constant Murley Shoulder Scores from 36.4 ± 4.8 pre-operatively to 86.6 ± 6.2 post-operatively and a decrease in visual analog scale scores from 7.2 ± 1.4 to 1.6 ± 0.4. Hardware-related complications occurred in 5 patients (10.9%): consisting of 4 cases (8.7%) of asymptomatic plate breakage and 1 case (2.2%) of fixation failure. In the complication group (n = 5), 80% (4/5) were activity-level patients, compared to 24.4% (10/41) in the non-complication group. High preinjury activity level identified as a potential risk factor for plate breakage (P = .018). However, this should be interpreted as a preliminary, hypothesis-generating finding rather than a definitive conclusion given the limited number of events.
Conclusion:
While SC hook plates are effective in restoring SCJ function, they are associated with a notable rate of fatigue-related hardware complications. These preliminary findings highlight the importance of prudent patient selection and suggest the hook plate functions best as a temporary stabilization solution.