Document Type: RESEARCH PAPER
Department of Orthopedics, Imam Khomeini Hospital, Urmia University of Medical Sciences, Urmia, Iran
Clinical Research Development Unit of Imam Khomeini Hospital, Urmia University of Medical Sciences, Urmia, Iran Department of Orthopedics, Imam Khomeini Hospital, Urmia University of Medical Sciences, Urmia, Iran
Background: This study was conducted to evaluate the clinical outcomes of the acromioclavicular joint (ACJ)
fixation with hook plate (HP) and continuous loop double endobutton fixation (CLDE) in the treatment of acute ACJ
Methods: This retrospective study was conducted on eight patients with HP and nine patients with CLDE fixations for
acute ACJ dislocations. The subjects were evaluated by various criteria, including disabilities of the Arm, Shoulder,
and Hand (DASH), American Shoulder and Elbow Surgeons Standardized Shoulder Assessment (ASES), University
of California, Los Angeles (UCLA) shoulder rating scale, Shoulder Constant score, Simple Shoulder Test (SST), and
coracoclavicular (CC) distance.
Results: The differences between the mean scores of the visual analog scale for pain, DASH, ASES, UCLA
shoulder rating scale, and Shoulder Constant, and SST were statistically significant in favor of the CLDE group.
Mean difference of CC distance was 8.6±0.9 mm in the HP group; however, it was 11.6±1.2 mm in the CLDE group.
The operation time was shorter in the HP fixation, compared to that in the CLDE fixation (51±13.3 versus 105±9.7
min; P<0.001 and P=0.008). There were six concomitant subacromial erosions and osteoarthritis in the ACJ of the
Conclusion: The CLDE fixation was reported with better clinical outcomes than HP fixation; however, it was a technically
demanding procedure. The HP maintained the CC distance better than CLDE with a technically easy application. The
HP requires a second surgery for the removal and development of subacromial erosion and osteoarthritis of the ACJ
that can be regarded as major concerns.
Level of evidence: III