Treatment of Tossy III Acromioclavicular Joint Injuries Using Hook Plates and Ligament Suture

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Abstract

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.

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