Treatment of type Rockwood III acromioclavicular joint dislocation with clavicular hook plate implantation in 56 cases

BACKGROUND: Which an ideal method to treat type Rockwood III acromioclavicular joint dislocation is, traditional or surgical therapy is still controversial. OBJECTIVE: To investigate the clinical effect of clavicular hook plate implantation on type Rockwood ? acromioclavicular joint dislocation. METHODS: A total of 56 patients with type Rockwood III acromioclavicular joint dislocation were selected from Department of Orthopaedics of Yiling Hospital between December 2005 and June 2008. There were 42 males and 14 females, aged 16-65 years and mean age of 32 years. All patients were treated with clavicular hook plate implantation. Indicators including visual analogue scale (VAS), the United States shoulder and elbow surgeon score (ASES), and Constant and Murley scoring system were tested pre-operatively, one year postoperatively, before internal fixation, and 3 months after internal fixation; additionally, functional changes of the shoulder joint and complications were analyzed before and after clavicular hook plate implantation. RESULTS AND CONCLUSION: The surgery and following-up were successfully achieved in 56 cases. The following-up lasted for 15-30 months, with the mean time of 20 months. The internal fixation was taken out at about 1 year after implantation. Coracoclavicular ligament was repaired in 32 cases but not in the 24 cases. Two patients with acromioclavicular joint dislocation recurrence were excluded, and coracoclavicular ligament therapy was not performed. Shoulder pain, foreign body sensation, and internal fixation failure occurred in two cases. One year after operation, VAS was decreased compared with that before operation, but ASES and Constant and Murley score were significantly increased (P < 0.01). At three months after internal fixation, VAS was decreased compared with that at 1 year after operation, but ASES and Constant and Murley score were increased (P < 0.05). The results demonstrated that clavicular hook plate implantation for treating type Rockwood ? acromioclavicular joint dislocation is simple and less invasive, thus it is an ideal internal fixation.