Treatment Of Acromioclavicular Dislocation With 15°"hook Plate Angle" Clavicle Hook Plate

Acromioclavicular joint dislocation is one of the common shoulder injuries.At present,there are more than 60 types of acromioclavicular joint dislocation[1][2],in which the clavicular hook plate internal fixation technique has matured in recent years and has become a surgical treatment of various shoulders.One of the preferred methods for dislocation of the joint[3].Although the literature reports that the excellent rate of clavicular hook plate for the treatment of acromioclavicular joint dislocation can reach 93.1%[4],the current controversy on the clavicular hook plate mainly lies in:subacromial osteolysis[5],subacromial impingement syndrome[6]And postoperative shoulder pain[7].We hope that the clavicular hook plate can be improved,and the postoperative complications can be minimized without affecting the therapeutic effect.In the past,we accidentally used the hook end of the hook plate to pre-bend 15°.After the follow-up,the pain symptoms of the patient were significantly reduced compared with the traditional 0° hook plate,and the shoulder joint function recovered well.So we pre-bend the hook end of the hook steel plate at a 15° angle and divided it into five parts.From the basic and clinical research,whether the 15° hook steel plate is more advantageous than the traditional 0° steel plate.In the first part,we implanted 0° and 15° clavicular hook plate into the bone model to simulate the operation.When we fixed the plate to the clavicle,the force required to press the 0° hook plate to the clavicle was significantly greater than 15°clavicle hook plate(48.0 N VS 35.5N),and excessive downforce may cause the screw to be pulled out and the fixing failed.The first part shows that the 15° hook steel plate is not easy to cause the screw to be pulled out after implantation,which is more advantageous than the 0° steel plate.In the second part,we implanted 0° and 15°clavicle hook plates into the model,respectively testing the hook end of the steel plate to the shoulder peak upward pressure.The results show that the 0° steel plate hook end to the shoulder peak upward pressure is significantly larger than the 15° steel plate(43.5N VS 18.0N),excessive pressure will cause the shoulder to be partially compressed and aggravate the pain.At the same time,the increased pressure will increase the friction.Excessive friction will also aggravate the symptoms of acromion dissolution and pain.Therefore,the second part shows that the effect of osteolysis and pain on the acromion after 15° plate implantation is better than 0° plate.In the third part,we implanted 0° and 15° clavicular hook plates into the model to measure the shackle distance(CCD)of the two steel plates.The results show that the impact of CCD on the 0° hook plate is significantly greater than 15°.Plate(31.5mm VS 35.5mm),and too small CCD can cause postoperative pain and affect functional recovery,that is,after 15° plate implantation,the patient’s pain symptoms and shoulder function recovery are better than 0° plate.In the fourth part,the patients with acromioclavicular joint dislocation were treated with 0° and 15° clavicular hook plates.The patients were followed up for at least 6 months.The results showed that the functional score of the 15° plate group was significantly better than that of the 0°group.The pain score of the patients in the plate group was significantly lower than that in the 0° plate group.That is to say,the fomctional recovery of the patients in the 15° plate group is better,and the postoperative pain symptoms are lighter.In the fifth part,we performed CT examination on the patients with 15° plate treatment to determine whether there was an impact between the hook end and the large tibial tuberosity.The results showed that the results of the imaging reconstruction analysis showed that the hook end of the clavicular hook plate was There is no clear impact between the large nodules.From the above five parts of the study,the 15° hook plate has advantages over the traditional 0° hook plate,and the patient recovers better and the postoperative pain is lighter.Although many shackle reconstruction devices are currently available and have good results[8],some of the distal clavicle fractures still require the use of clavicular hook plates[9].If the hook plate is pre-bent 15°,a simple improvement can achieve better clinical results and reduce complications,which can give doctors a choice.At present,most of the mainstream reconstruction of sacral ligament consumables are imported and expensive,and the domestic hook steel plate is cheap,suitable for China’s national conditions,and can greatly reduce the per capita cost.In the current macro environment of medical insurance control fees,it is one of the economically effective choices.The hook plate operation is simple and the learning curve is short[10],which is conducive to the promotion of primary hospitals.