Repair of complete acromioclavicular separations using the acromioclavicular-hook plate

Complete Tossy III acromioclavicular separations in 21 male patients (according to the Rockwood classification: 7 Type III and 14 Type V lesions) with a mean age of 31 years were treated by surgical repair with the acromicroclavicular-hook plate within a period of 6 years. The population consisted of 18 patients with acute injuries and 3 with old injuries. Six patients experienced infections and delayed wound healing; osteitis did not occur. In 1 case, delayed wound healing was combined with dislocation of the hook. Bending of the implant occurred in another patient. Sixteen patients underwent clinical and radiographic followup at a mean of 38 months. Four patients who had no complications and free mobility of the shoulder joint at the end of treatment after removal of the implant did not appear for followup. One patient died of a malignant brain tumor. According to a modified evaluation system by Poigenfürst et al, clinical and radiographic findings showed 8 excellent, 7 good, and 1 poor result. A secondary widening of the hook hole in the acromion was seen in 13 patients; this was related to the large range of motion of the acromioclavicular joint. Calcifications and ossifications in the coracoclavicular ligaments, diastases in the acromioclavicular joint, and redislocations were not significantly different when this method was compared with other surgical techniques as reported in the literature. Use of the acromioclavicular-hook plate permits retention in the transverse plane without impairing the joint itself, but the technique is challenging.