Abstract:

BACKGROUND: It is still controversial in clinical practice whether the hook plate should be removed or not timely after surgical treatment on acromioclavicular joint dislocation.
OBJECTIVE:To evaluate the necessity of early hook plate removal after surgery on Rockwood type Ⅲ acromioclavicular joint dislocation by follow-up with shoulder functional assessment and radiographic measurement.
METHODS: Seventy-four cases of acute traumatic acromioclavicular dislocation (Rockwood type Ⅲ) treated with hook plate internal fixation were followed up. All patients were divided into either removal group with plate removal and retaining group without removal.
RESULTS AND CONCLUSION: There were no significant differences of each indicator in the removal group before internal fixation and retaining group after half one year. Constant score, activities of daily living, range of motion and Oxford Shoulder Score (OSS) scores after removal were significantly higher than those of before removal (P < 0.05), However, pain and strength scores showed no significant difference. At 1 year after internal fixation, compared with the retaining group, constant score, activities of daily living, range of motion and OSS score were increased in the removal group (P < 0.05), and pain, strength, coracoclavicular distance and acromioclavicular width were not significantly changed. There were no postoperative infection and complications of re-fracture and plate breakage in all the cases, and significant systemic and local reactions were also not found. It is indicated that shoulder function rehabilitation can be reached by improving Constant and OSS score after exercise if hook plate can be early removed after internal fixation in the treatment of acromioclavicular dislocation. Meanwhile, the anatomy of acromioclavicular joint remains the same and further complications can be reduced.