Artikel
Intraoperative-Bended Hookplate With Tendon Graft For Revision Acromio-Clavicular Stabilization
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Veröffentlicht: | 25. Oktober 2022 |
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Gliederung
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Objectives: Revision surgery for failure of a primary acromio-clavicular joint stabilization with continues functional limitation and pain in the shoulder is a real challenge. Many different techniques with as many different implants have been described.
We present an alternative technique to preserve as much bone as possible of the clavicle not to weaken any more the distal clavicle and coracoid.
Methods: Using an intra-operative bended hookplate creates a tunnel on top of the clavicle. This allows a tendon graft to be placed around the clavicle and the corocoid. This way, we do not make any extra tunnels through the lateral clavicle or coracoid and optimize the effect of the graft.
As the hookplate irritates the subacromial space, we have to remove the plate 4 months after the stabilizing procedure leaving the tendon graft intact.
The technique allows the patient to start moving day one postoperative the shoulder up to 90° and building up to 150° at 4 months. Total elevation is only achieved after removal of the hookplate.
Results: The patients feel comfortable and stable immediately after surgery and at 6 months postop a normal range of motion is recovered with good strength.
Conclusion: Using an intraoperative bended hookplate allows a tendongraft to be placed around the clavicle avoiding making extra tunnels in the bone. As the tendon runs under the curve in the plate, the plate can easily be removed after 4 months without taking down the graft.
Patients feel very comfortable immediately after the surgery. The only disadvantage is that removal of the plate is mandatory to achieve a perfect result 6 months after the initial procedure.