Abstract:

BACKGROUND: Now the studies on hook plate are mainly the curative effect and complications after internal fixation, but studies about symptoms and corresponding imaging changes after removing internal fixation are rarely.
OBJECTIVE: To discuss the symptoms and imaging changes after removing hook plate and the necessity of removing hook plate.
METHODS: Totally of 87 patients with the hook plate for the treatment of Neer Ⅱ type of distal clavicle fractures and Tossy Ⅲ type acromioclavicular joint dislocation were selected from Department of Orthopedics, the 101 Hospital of Chinese PLA between January 2009 and January 2011. There were 54 males and 33 females, aged 20-61years old with the average age of 39.8 years. All the patients were taken conventional X-ray after the hook plate removal. Shoulder joint function was tested by using Constant-Murley score system before and after the hook plate removal.
RESULTS AND CONCLUSION: All the 87 patients were followed-up for 8 to 18 months. The hook plate was removed at about 12 weeks. Wound healing was well and without infection, fixation fracture and hook loosening. Constant-Murley score after the hook plate removal was significantly increased as compared with that before removing the plate (P < 0.001), except 8 cases were opposite which corresponding X-ray films were mainly represented bone absorption, acromioclavicular arthritis and acromion degeneration. The X-ray films explained why the score in the eight cases was opposite and this could be regarded as the diagnostic criteria to guide clinical treatment after removing fixation. It is recommended that the fixation should be timely removed after the shoulder ligaments (acromioclavicular ligament coracoclavicular ligament) healing.