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Hook plate fixation with coracoclavicular suspensory suture augmentation for Rockwood grade V acromioclavicular joint dislocation in recreational sports activity
Arthrosc Orthop Sports Med 2022;9:57-66
Published online November 1, 2022;  https://doi.org/10.14517/aosm22017
© 2022 Korean Arthroscopy Society and Korean Orthopedic Society for Sports Medicine.

Sun-Kyu Kim*, Jewon Jung*, Min Soo Shon

Department of Orthopedic Surgery, National Medical Center, Seoul, Korea
Correspondence to: Min Soo Shon, https://orcid.org/0000-0002-0012-595X
Department of Orthopedic Surgery, National Medical Center, 245 Eulji-ro, Jung-gu, Seoul 04564, Korea. Tel: +82-2-2260-7198, Fax: +82-2-2278-9570, E-mail: minsoo.shon@nmc.or.kr
*These authors contributed equally to this work as co-first authors.
Received September 6, 2022; Revised October 7, 2022; Accepted October 10, 2022.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: This study aimed to investigate the outcomes of hook plate fixation with coracoclavicular (CC) suspensory suture augmentation for acute Rockwood grade V acromioclavicular joint (ACJ) dislocation in patients engaging in recreational activity.
Methods: This retrospective study was performed on 25 patients who underwent hook plate fixation combined with CC suspensory suture augmentation for acute Rockwood grade V ACJ dislocation that occurred during recreational activity in National Medical Center. Clinical outcomes and patient-rated satisfaction were assessed on the final follow-up. Radiographic changes, including CC distance (CCD) and proportional length differences (PLD), were assessed at the preoperative, first (i.e., immediately after implant removal), and final evaluation times.
Results: After a mean of 23.7 months for final follow-up, the mean numeric rating scale for pain, Constant–Murley, University of California at Los Angeles, and American Shoulder and Elbow Surgeons scores were 0.9, 91.2, 30.8, and 86.7 respectively, and only one patient subjectively complained of shoulder stiffness. Compared with the mean preoperative CCD (17.5 mm) and PLD (155.4%), the CCD (P < 0.001, 7.9 mm) and PLD (P < 0.001, 3.7%) significantly improved at the first evaluation time (mean 6.1 mo). There were no significant deteriorations in the mean CCD and PLD on the serial evaluations (P = 0.107). Minimal erosion around the hook was observed in five patients, all of which were asymptomatic. There were no other major complications. All patients returned to their recreational activity level before the index injury. Patient-rated satisfaction was good to excellent.
Conclusion: This study demonstrated good clinical outcomes and relatively less complications after hook plate fixation with CC suspensory suture augmentation for acute Rockwood grade V ACJ dislocation in patients engaging in recreational activity. On serial follow-ups, radiographic outcome was maintained without significant additional displacement, even after the CC-augmented sutures and the plate removal.
Keywords : Acromioclavicular joint; Coracoclavicular ligament; Acromioclavicular joint dislocation; Hook plate; Suspensory suture augmentation
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