Study on the effect of distal clavicle-acromion coronal angle on the treatment with clavicle hook plate
Objective To investigate the relationship between distal clavicle-acromion coronal angle(α angle)and therapeutic effect,and analyze the feasibility of α angle as an predictive factor of the therapeutic effect while using clavicle hook plate.Methods A retrospective analysis was conducted on 267 patients with acromioclavicular dislocation or distal clavicle fracture treated with clavicle hook plate from January 2013 to June 2021.There were 125 cases of traffic accident,86 cases of fall injury,42 cases of drop injury and 14 cases of crush injury.Clavicle distal fracture of Neer type Ⅱ:98 cases.Acromioclavicular dislocation of Rockwood type Ⅲ/Ⅳ/Ⅴ:128/15/26 cases.The patients were divided into three groups by α angle.Group A:0°<α<20°,110 patients;Group B:20°<α<30°,101 patients;Group C:α>30°,56 patients.The relation between complication rate and α angle was calculated.The relationship between the classifications of distal clavicle fracture and acromioclavicular dislocation,and the complication rate were also analyzed.Results There were 38 cases of total complications,including 3 cases of screw loosening,1 case of steel plate breakage,1 case of hook rupture,6 cases of unhooking,3 cases of fracture displacement,1 case of fracture around the proximal plate and 23 cases of severe shoulder pain with limited mobility,among whom 12 cases of rotator cuff was diagnosed.There was no relationship between classifications of distal clavicle fracture,acromioclavicular dislocation and the complication rate in this study(P>0.05).The total complication rate of Group C was greater than that of Group A and B(P<0.001).The rates of unhooking and rotator cuff rate were higher in the Group C than that in the Group A and B(P<0.05).The rate of severe shoulder pain with limited mobility in Group B was lower than that in the Group A and C(P<0.05).Conclusions α angle is an influential factor for the treatment effect with clavicle hook plate.Larger α angle can increase the complication rate of clavicle hook plate treatment,especially the unhooking rate.It can be used as a preoperative judgment index to select the hook plate,further improving the prognosis of patients.
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