Biomechanical analysis of clavicle hook plate implantation with different hook angles in the acromioclavicular joint

Int Orthop. 2017 Aug;41(8):1663-1669. doi: 10.1007/s00264-016-3384-z. Epub 2017 Jan 18.

Abstract

Purpose: A clavicle hook plate is a simple and effective method for treating acromioclavicular dislocation and distal clavicle fractures. However, subacromial osteolysis and peri-implant fractures are complicated for surgeons to manage. This study uses finite element analysis (FEA) to investigate the post-implantation biomechanics of clavicle hook plates with different hook angles.

Methods: This FEA study constructed a model with a clavicle, acromion, clavicle hook plate, and screws to simulate the implantation of clavicle hook plates at different hook angles (90°, 95°, 100°, 105°, and 110°) for treating acromioclavicular joint dislocations. This study investigated the biomechanics of the acromion, clavicle, hook plate, and screws.

Results: A smaller hook angle increases the stress on the middle third of the clavicle. A larger hook angle increases the force exerted by the clavicle hook plate on the acromion. The screw at the most medial position on the plate generated the highest stress. The highest stress on the implanted clavicle hook plate was on the turning corner of the hook.

Conclusions: A clavicle hook plate with different hook angles may induce different biomechanical behaviors in the clavicle and acromion. Orthopedic surgeons must select a suitable clavicle hook plate based on the anatomical structure of each patient.

Keywords: Acromioclavicular joint dislocation; Biomechanics; Clavicle hook plate; Finite element analysis.

MeSH terms

  • Acromioclavicular Joint / injuries
  • Acromioclavicular Joint / physiopathology
  • Acromioclavicular Joint / surgery*
  • Acromion / physiopathology
  • Acromion / surgery
  • Biomechanical Phenomena
  • Bone Plates*
  • Bone Screws
  • Clavicle / injuries
  • Clavicle / physiopathology
  • Clavicle / surgery
  • Computer Simulation
  • Finite Element Analysis
  • Fracture Fixation, Internal / instrumentation
  • Fracture Fixation, Internal / methods*
  • Fractures, Bone / physiopathology
  • Fractures, Bone / surgery
  • Humans
  • Joint Dislocations / physiopathology
  • Joint Dislocations / surgery*