Clin Should Elbow.  2018 Sep;21(3):138-144. 10.5397/cise.2018.21.3.138.

Evaluation of the Acromioclavicular Joint Morphology for Minimizing Subacromial Erosion after Surgical Fixation of the Joint Using a Clavicular Hook Plate

• Kim SJ
• Kee YM
• Park DH
• Ko YI
• Lee BG

• KMID: 2436399
• DOI: http://doi.org/10.5397/cise.2018.21.3.138

Abstract

BACKGROUND
Subacromial erosion remains a major concern after surgical fixation of acromioclavicular (AC) joint using a clavicular hook plate. To minimize postoperative subacromial erosion, we investigated the structural relationship between distal clavicle and acromion around the AC joint by considering the surgical fixation of the joint using the hook plate technique.
METHODS
Computed tomography scans of 101 AC joints without any inherent pathology were analyzed. The angle between the distal clavicle and acromion around the AC joint (AC angle), depth of the acromion, differences in height between distal clavicle and acromion (AC height difference), and thickness of distal clavicle and acromion at the AC joint were measured. Descriptive statistics were calculated for each anatomical parameter, and all results were compared between gender groups.
RESULTS
The mean AC angle was 17.1°(range, −8.0° to 39.0°), and the mean AC height difference was 3.5 mm (range, −0.7 to 8.7 mm). Both factors showed very high variability (coefficients of variation=62.6% and 46.6%, respectively). The mean AC angle was significantly higher in the female gender than in the male gender (19.8° vs. 13.8°, p=0.048). The mean acromion thickness and distal clavicular thickness were both significantly thinner in the female group than in the male group (p < 0.001)
CONCLUSIONS
Taken together, we believe our results might be helpful in minimizing postoperative subacromial erosion when performing surgical fixation of the AC joint using the hook plate, and be valuable in improving future design of the hook plate.

Keyword

Acromioclavicular joint; Joint dislocations; Shoulder fractures; Hook plate; Subacromial erosion

MeSH Terms

Acromioclavicular Joint*
Acromion
Clavicle
Female
Humans
Joints*
Male
Pathology
Shoulder Fractures