HoeJeong Chung1, DooSup Kim2, Scott A Banks3, JongSang Son4,5, YoungHo Kim6, MyoungGi On1, JunSeop Yeom1. 1. Department of Orthopaedic Surgery, Wonju College of Medicine, Yonsei University Wonju Severance Christian Hospital, Ilsan-ro 20, Wonju-si, Gangwon-do, 26426, Republic of Korea. 2. Department of Orthopaedic Surgery, Wonju College of Medicine, Yonsei University Wonju Severance Christian Hospital, Ilsan-ro 20, Wonju-si, Gangwon-do, 26426, Republic of Korea. dskim1974@yonsei.ac.kr. 3. Department of Mechanical and Aerospace Engineering, University of Florida, Gainesville, FL, USA. 4. Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Chicago, IL, 60611, USA. 5. Department of Physical Medicine & Rehabilitation, Northwestern University, Chicago, IL, 60611, USA. 6. Department of Biomechanical Engineering, Yonsei University, Wonju, Gangwon, South Korea.
Abstract
PURPOSE: Acromioclavicular-coracoclavicular ligament injury occurs frequently, and the clavicle hook plate technique is an easy-to-use treatment method. However, complications such as subacromial impingement syndrome, synovitis, erosion, osteolysis, post-operative pain, and post-operative limitations in range of motion have been reported. We aimed to evaluate the use of the clavicle hook plate in the shoulder joints and to compare in vivo three-dimensional (3D) scapular kinematics and scapulohumeral rhythm between the shoulders with a clavicle hook plate and contralateral normal shoulder joints. METHODS: Ten male patients (aged 40.5 ± 14.4 years) who underwent clavicle hook plate fixation for an acromioclavicular-coracoclavicular ligament injury were selected. Computed tomography and fluoroscopy were conducted on both the shoulder joints, and 3D models were created. Using a 3D-2D model-image registration technique, we determined the 3D coordinates of the scapula, and we measured the scapular kinematics and scapulohumeral rhythm. RESULTS: The values for upward rotation, posterior tilt, and external rotation in the two groups increased in proportion with humeral elevation, showing significant differences between the two groups (p < 0.05). Overall, the value in the clavicle hook plate group (group H) was smaller than that in the control group (group C) by 23.5% (6.7°) of upward rotation and 64.8% (18.9°) of posterior tilt. However, the external rotation in group H was greater than that in group C by 32.3% (2.3°). In overall value, there was a significant difference not in upward rotation and external rotation, but in posterior tilt. During humeral elevation, the overall changes in scapulohumeral rhythm were 4.65 ± 2.45 in group H and 3.8 ± 0.8 in group C, and statistical differences were not detected between the two groups. CONCLUSIONS: Clavicle hook plate fixation changes the scapular kinematics and scapulohumeral rhythm; thus, when clavicle hook plate fixation is complete, the implant should be promptly removed.
PURPOSE:Acromioclavicular-coracoclavicular ligament injury occurs frequently, and the clavicle hook plate technique is an easy-to-use treatment method. However, complications such as subacromial impingement syndrome, synovitis, erosion, osteolysis, post-operative pain, and post-operative limitations in range of motion have been reported. We aimed to evaluate the use of the clavicle hook plate in the shoulder joints and to compare in vivo three-dimensional (3D) scapular kinematics and scapulohumeral rhythm between the shoulders with a clavicle hook plate and contralateral normal shoulder joints. METHODS: Ten male patients (aged 40.5 ± 14.4 years) who underwent clavicle hook plate fixation for an acromioclavicular-coracoclavicular ligament injury were selected. Computed tomography and fluoroscopy were conducted on both the shoulder joints, and 3D models were created. Using a 3D-2D model-image registration technique, we determined the 3D coordinates of the scapula, and we measured the scapular kinematics and scapulohumeral rhythm. RESULTS: The values for upward rotation, posterior tilt, and external rotation in the two groups increased in proportion with humeral elevation, showing significant differences between the two groups (p < 0.05). Overall, the value in the clavicle hook plate group (group H) was smaller than that in the control group (group C) by 23.5% (6.7°) of upward rotation and 64.8% (18.9°) of posterior tilt. However, the external rotation in group H was greater than that in group C by 32.3% (2.3°). In overall value, there was a significant difference not in upward rotation and external rotation, but in posterior tilt. During humeral elevation, the overall changes in scapulohumeral rhythm were 4.65 ± 2.45 in group H and 3.8 ± 0.8 in group C, and statistical differences were not detected between the two groups. CONCLUSIONS: Clavicle hook plate fixation changes the scapular kinematics and scapulohumeral rhythm; thus, when clavicle hook plate fixation is complete, the implant should be promptly removed.
Authors: Christopher W Kolz; Hema J Sulkar; Klevis Aliaj; Robert Z Tashjian; Peter N Chalmers; Yuqing Qiu; Yue Zhang; K Bo Foreman; Andrew E Anderson; Heath B Henninger Journal: J Biomech Date: 2021-01-23 Impact factor: 2.712