Clinical results of treatment using a clavicular hook. Use of the ao hookplate for treatment of unstable fractures. Surgical fixation of lateralthird clavicle fractures with a hook plate is an effective technique resulting in excellent rate of union and relatively good functional outcome. Midterm results after operative treatment of rockwood grade iiiv acromioclavicular joint dislocations with an achookplate. Plates superior lateral plate anterior midshaft plate anterior lateral plate lateral hook plate clavicle fractures have long been treated nonoperatively. Clavicular hook plates hps are an effective option but. Hook plate, medial clavicle fracture, sternoclavicular dislocation i ntroduction the articulation of the clavicle medially with the manubrium of the sternum forms the sternoclavicular joint and represents the only articular link to the axial skeleton, the remainder of the pectoral girdle being suspended by the muscles. This was augmented with autologous iliac crest bone graft. Clavicle system offers three families of plating solutions based on varied fracture patterns and surgeon preference.
We aimed to discover the risk factors for this complication and the influence of these risk factors on patients and to suggest. Clinical results of treatment using a clavicular hook plate. The clavicle hook plate provides a single solution for fixation of both lateral clavicle fractures and acromioclavicular joint injuries. Plates utilize smartlock technology which permits polyaxial screw placement. Jan, 2007 we used a new internal fixative implant, the ao clavicle hook plate, for treatment of unstable fractures of the distal clavicle. This is thought to stem from problems associated with the hook plate causing impingement symptoms, which. However, studies have shown that fractures with comminution andor significant displacement may be better served with surgical intervention1.
Teach home exercises o pendulum movements o active assisted passive flexion and abduction to 90 degrees elevation. Clavicular hook plate may induce subacromial shoulder. Clavicular hook plate for gradeiii acromioclavicular dislocation. The acumed clavicle plating system provides surgeons with the ability to address acute fractures, malunions, and nonunions of the clavicle with 33 different claviclespecific plating options.
Surgical treatment of distal clavicle fractures using the. Evaluation of the clavicle hookplate for treatment of acrom. Controversy exists with the use of the acromioclavicular hook plate for the treatment of lateralthird clavicle fractures neer type ii. The purpose of this metaanalysis was to compare clavicle hook plates versus distal clavicle locking plates for the treatment of neer type ii distal clavicle fractures. Pdf evaluation of a clavicle hook plate for fixation of. Pdf hookplate fixation of unstable lateral clavicle fractures.
Because locking plate fixation maintains the biomechanics of the acromioclavicular joint, it allows some degree of early mobilization and does not require reconstruction of the coracoclavicular ligaments 23. This document is intended solely for the use of healthcare professionals. Hook plate for medial clavicle fracture pubmed central pmc. The patients were operated on within 7 days of the injury using a clavicle hookplate stratec medical, oberdorf, switzerland. Eight freshfrozen cadaveric shoulders with a mean age of 48 years range, 3769 were utilized. The variax 2 clavicle plating systems provides surgeons with a comprehensive range of anatomic plating options that work with a common instrument and screw platform. Using the plate with 15 mm hook depth, pass the hook under the acromion.
Kienast b, thietje r, queitsch c, gille j, schulz ap, meiners j. Clavicle hook depth and impingement syndromea cause. Evaluation of the clavicle hook plate for treatment of. Clavicle hook plate fixation for displaced lateralthird. Dec 30, 2019 compared with the clavicle hook plate, the distal clavicle locking plate was associated with increased constantmurley scores at 3 months and 6 months. Fifteen consecutive patients with unstable fractures of the distal clavicle neer type ii were treated using ao clavicle. Lcp clavicle hook plate surgical technique depuy synthes. This plate and screw construct allows rotational mobility of the shoulder. The lcp clavicle hook plate is available in different lengths and hook sizes with a left and right version for optimal sizing and screw positioning for each individual patient. From 1999 to 2003, 34 patients with unstable distal clavicular fractures neer type 2 had surgery using the acromioclavicular titanium hook plate. Jun 23, 2015 the variax clavicle locking plate system is an anatomically shaped, variable angled locking plate system. Clavicle hook plates features clavicle hook plate enhances healing capacity resulting in several ways. Fifteen consecutive patients with unstable fractures of the distal clavicle neer type ii were.
To describe surgical technique for proper placement of the clavicle hook plate, determine if there is subacromial impingement caused by hook plate fixation, and evaluate the mechanical strength of the clavicle hook plate construct. Because the plate is fixed on the clavicle superiorly and the hook of the plate was inserted posterior to the ac joint, there is an underlying assumption that the hooked portion of the plate may predispose to subacromial impingement,18,20. The position and angulation of the screws depends on the fracture configuration. This subacromial hook provides distal leverage that allows the portion of the plate that is fixed to the clavicle to act as a depressor, bringing. Posterior positioning of a clavicle hook plate is a risk. The clavicle plating system offers low and narrowprofile plate solutions that are precontoured to match the natural shape of the clavicle. The fixation system with angular stability for lateral clavicle fractures and acromioclavicular joint injuries. The clavicle hook plate has been commonly used to treat distal clavicle fractures and acromioclavicular ac joint dislocations. One weakness of this study is that conclusions are only based on one case, always hardly sufficient to make a generalized conclusion.
Evaluation of the clavicle hook plate for treatment of acrom. Clavicle hook depth and impingement syndromea causeeffect. Clavicle hook plate offers a low profile solution for superior distal plating of the clavicle. The clavicle plate and screw system is a comprehensive set of plates, screws, and instruments designed to treat midshaft and distal clavicle fractures. Once the plate shaft is placed on the clavicle, the end of the hook should be in. The hook plate was removed after 16 weeks in 17 patients with no complication.
However, the hook may cause rotator cuff tears and subacromial impingement, which adversely affect the clinical results. Pdf hook plate for medial clavicle fracture arndt schulz. Moreover, implantations of clavicle hook plates made of different materials stainless steel and titanium alloy and with different depths 12, 15, and 18 mm in patients with. Pdf hookplate fixation of unstable lateral clavicle fractures has given promising results in previous reports, but numbers of patients have been. Surgical technique this publication is not intended for distribution in the usa.
Work with your doctor and physical therapist to design a custom rehab program that is appropriate for your condition. Midshaft clavicle fracture following osteosynthesis with a. Standard orif procedures including, pinning, reconstruction, and dc plating are not appropriate for preserving acromioclavicular joint function. Clavicle hook plate versus distal clavicle locking plate for. The stainless steel plates are low profile and precontoured with locking and nonlocking screw options in each plate. Place the shaft of the plate onto the superior aspect of the clavicle. The acumed clavicle plating system provides surgeons with the ability to address acute fractures, malunions, and nonunions of the clavicle with 33 different clavicle specific plating options. Eight freshfrozen cadaveric shoulders with a mean age of 48 years range, 3769 were used. Several studies have reported that this hook plate also showed good outcomes when used for neer type ii distal clavicle fracture fixation. This study established four parts using computer models. Biomechanical analysis of implanted clavicle hook plates with.
This study describes the operative procedure and the clinical results obtained, as well as discussion of the advantages and problems encountered. However, complications such as plate fracture due to trauma, nonunion, and plate loosening can occur, albeit at a lower frequency, and some cases require reoperation 18, 19. Variax clavicle locking plate system stryker meded. Feb 06, 2014 because the plate is fixed on the clavicle superiorly and the hook of the plate was inserted posterior to the ac joint, there is an underlying assumption that the hooked portion of the plate may predispose to subacromial impingement,18,20.
Open subtypes 2 your digital gateway to expertise, education, and innovation. This helps create an improved environment for bone healing, accelerating the patients return to previous mobility and function. Clavicle orif rockwood pin hook plate inpatient confirm from op notes patient to follow protocol. Pdf clinical results of treatment using a clavicular. The lcp clavicle hook plate, combined with ao technique, provides stable fracture fixation with minimal trauma to vas cular supplies. Clavicle hook plates features dynamic compression screw holes accept 3. Aug 01, 2012 this subacromial hook provides distal leverage that allows the portion of the plate that is fixed to the clavicle to act as a depressor, bringing the medial fracture fragment down to facilitate. This program is designed to improve the functional mobility of your shoulder and arm. Lcp clavicle hook plate depuy synthes pdf catalogs. Evaluation of the clavicle hookplate for treatment of.
Clavicle hook plate versus distal clavicle locking plate. Clavicular hook plate for gradeiii acromioclavicular. The operation was carried out by the surgeon on duty and there were 23 operating surgeons. Biomechanical analysis of implanted clavicle hook plates. Ao clavicular hook plate fixation provides more rigid fixation and good bony union rates for neer type ii distal clavicular fractures. The hook plate allows rotatory movements between acromion and clavicle 4.
If there is difficulty lowering the plate shaft onto the clavicle, then the plate with 18 mm hook depth should be used. We found that there was no significant difference between the occurrence of delayed union between the clavicle hook plate and distal clavicle locking plate groups. Clavicle fractures have long been treated nonoperatively. The system was designed to allow both intuitive fit, and intraoperative. Clavicle hook plate fixation for distalthird clavicle. Treatment of distal clavicle fractures using a scorpion. Instruments and implants approved by the ao foundation. This is thought to stem from problems associated with the hook plate causing impingement symptoms, which can cause longterm limitation of movement and pain.
The acumed clavicle plating system is intended to provide fixation for fractures, malunions, and nonunions of the clavicle. Tplate fixation is another surgical method of treatment for unstable clavicle fractures, and its clinical efficacy has been. Clavicular hook plates are effective fixation devices for lateral end clavicle fractures and acromioclavicular joint dislocations and have been extensively used in the last decade. Anatomically precontoured, rounded shaft profile minimizes the risk of soft tissue irritation between the plate and surrounding soft tissue, the acromioclavicular joint and the rotator cuff, undercuts in shaft reduce impairment of blood supply, wide variety of plates optimize implant selection. Evaluation of a clavicle hook plate for fixation of unstable distal end comminuted clavicle fractures. Clavicle hook plate fixation for distalthird clavicle fracture neer type ii. The clavicular hook plate is designed to fit anatomically to the acromion and clavicle, with the hook extending from the plate acting as a lever beneath the acromion as shown in figure 4b. The outcome of hook plate for lateral third clavicle fractures.
Although this plate achieves a high percentage of union, there are concerns about subacromial osteolysis and impingement of supraspinatus tendon. All surgical techniques are available as pdf files at. The lcp clavicle hook plate, combined with ao technique, provides stable fracture fixation with minimal trauma to vascular supplies. Introduction clavicle fractures account for around 2. Distal clavicle fracture repair using coracoid fixation duration.
The response ortho clavicle hook plate is designed to be a comprehensive solution for repairing fractures located at the distal portion of the clavicle and acromioclavicular separations. Clavicle hook plate plate lengths from 67106mm 4 to 8 holes three hook depth options. Variable angle locking plate system for treating clavicle fractures. The hook plate is a promising approach for the operative treatment of medial clavicle fractures. Mar 19, 2020 the clavicle hook plate has been commonly used to treat distal clavicle fractures and acromioclavicular ac joint dislocations. Pubmed 1996 to january 2019, embase 1980 to january 2019, web of science 1990 to january 2019, the cochrane library january 2019, and the china national knowledge infrastructure. To describe surgical technique for proper placement of the clavicle hook plate, determine whether there is subacromial impingement caused by hook plate fixation, and evaluate the mechanical strength of the clavicle hook plate construct. The variax clavicle locking plate system is an anatomically shaped, variable angled locking plate system. Distal clavicle plate to aid in the repair of clavicle fractures. In addition, the distal clavicle locking plate was associated with a decrease in the occurrence of shoulder pain and the number of restricted shoulder abduction range of motion cases. The clavicle may be stabilized either with fixation placed superiorly or anteriorly based.
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