Madi Sandesh, Pandey Vivek, Murali Sujayendra, Acharya Kiran
Department of Orthopaedics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India.
J Clin Orthop Trauma. 2022 Mar 4;27:101825. doi: 10.1016/j.jcot.2022.101825. eCollection 2022 Apr.
Hook plate (HP) is a popular implant of choice in the management of highgrade acute acromioclavicular joint (ACJ) dislocations. Recently, suspensory loop systems have drawn significant interest with comparable results and additionally does not warrant implant removal. However, no studies have compared the outcomes of HP vis-a-vis Dog Bone TM Button with dual FiberTape® (DB).
38 patients who underwent HP or Arthroscopic assisted single tunnel DB fixation to stabilize high-grade ACJ dislocations were retrospectively included in study for clinically and radiological evaluation at a minimum follow up of one year. American Shoulder and Elbow Society and Constant Murley scores were used for clinical assessment. The radiological evaluation was done by assessing quality of reduction, measuring coracoclavicular distance (CCD), and extent of subacromial erosion.
For final follow up evaluation, both HP and DB group had 16 patients each. The mean follow-up was 55.38 ± 10.9 and 32.88 ± 14.0 months in HP and DB group, respectively. No significant difference in mean ASES (p=0.71) and CM score (p=0.62) was found between the two groups. The DB group revealed higher CCD at the final follow-up compared to the HP group (p=0.01). Although statistically insignificant, there were more subluxations and dislocations in the DB group (37.5%) compared to the HP group (25%). The subacromial erosion was noted in all cases of the HP group at time of implant removal.
Both groups revealed satisfactory functional and radiological outcome. However, the DB group showed a higher tendency of loss of reduction.
钩钢板（HP）是治疗重度急性肩锁关节（ACJ）脱位的常用植入物。近来，悬吊环系统引起了广泛关注，其效果相当且无需取出植入物。然而，尚无研究比较HP与双纤维带（DB）的犬骨TM纽扣的疗效。
回顾性纳入38例行HP或关节镜辅助下单隧道DB固定术以稳定重度ACJ脱位的患者，进行至少一年的临床和影像学评估。采用美国肩肘协会和Constant Murley评分进行临床评估。通过评估复位质量、测量喙锁间距（CCD）和肩峰下侵蚀程度进行影像学评估。
末次随访评估时，HP组和DB组各有16例患者。HP组和DB组的平均随访时间分别为55.38±10.9个月和32.88±14.0个月。两组间平均ASES评分（p=0.71）和CM评分（p=0.62）无显著差异。与HP组相比，DB组在末次随访时CCD更高（p=0.01）。虽然无统计学意义，但DB组（37.5%）的半脱位和脱位比HP组（25%）更多。HP组所有病例在取出植入物时均发现肩峰下侵蚀。
两组均显示出满意的功能和影像学结果。然而，DB组显示出更高的复位丢失倾向。
