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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2012 August;63(4):271-8
Rockwood type III Acromioclavicular dislocation: clinical and x ray review after treatment with clavicle Hook Plate
Guizzi P., Quadri V., Claudio M., Moretta M.
Operative Unit of Orthopedics and Traumatology, Gardone Val Trompia Hospital, Spedali Civili di Brescia Hospital, Brescia, Italy
aim. Our work has the purpose to discuss and report our results using the clavicular Hook plate for the treatment for acromioclavicular dislocation. 12 patients with Rockwood type III dislocation undergone clinical and radiological review after treatment with Hook plate.
Methods. From July 2006 to June 2010 we treated 12 patients with Acromioclavicular dislocation Rockwood type III by open reduction and fixation using a clavicular Hook Plate. All patients were examined with a mean follow-up of 21 months (range 5-37) after the removal of the plate. The Oxford Shoulder Score, Simple Shoulder Test and the Constant Score was assessed at the follow-up examinations. Stress loaded 5 Kg radiographs of both shoulders were taken.
Results. The mean Constant Score on the affected shoulder was 93.23, the mean Oxford Shoulder Score was 14.74 and the mean Simple Shoulder Test was 11.83. Five patients presented bone resorption under the hook. The coracoclavicular distance on 5 kg stress loaded radiographs range from 3 to 15 mm and the mean difference from the unaffected shoulder was 2.1 mm. There was no plate breakage. One patient had a superficial wound infection which responded to antibiotics.
Conclusion. Clavicular hook plate fixation is an effective treatment for Rockwood type III Acromioclavicular dislocation. Choosing the correct hook depth of the plate is fundamental. Excessive movement of the gleno-humeral articulation before removing the device could carry to radiologic changes not always clinical related. The plate should be removed to regain full range of motion and avoid residual pain.