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Erschienen in: International Orthopaedics 11/2015

01.11.2015 | Original Paper

Biomechanical analysis of acromioclavicular joint dislocation treated with clavicle hook plates in different lengths

verfasst von: Cheng-Min Shih, Kui-Chou Huang, Chien-Chou Pan, Cheng-Hung Lee, Kuo-Chih Su

Erschienen in: International Orthopaedics | Ausgabe 11/2015

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Abstract

Purpose

Clavicle hook plates are frequently used in clinical orthopaedics to treat acromioclavicular joint dislocation. However, patients often exhibit acromion osteolysis and per-implant fracture after undergoing hook plate fixation. With the intent of avoiding future complications or fixation failure after clavicle hook plate fixation, we used finite element analysis (FEA) to investigate the biomechanics of clavicle hook plates of different materials and sizes when used in treating acromioclavicular joint dislocation.

Methods

Using finite element analysis, this study constructed a model comprising four parts: clavicle, acromion, clavicle hook plate and screws, and used the model to simulate implanting different types of clavicle hook plates in patients with acromioclavicular joint dislocation. Then, the biomechanics of stainless steel and titanium alloy clavicle hook plates containing either six or eight screw holes were investigated.

Results

The results indicated that using a longer clavicle hook plate decreased the stress value in the clavicle, and mitigated the force that clavicle hook plates exert on the acromion. Using a clavicle hook plate material characterized by a smaller Young’s modulus caused a slight increase in the stress on the clavicle. However, the external force the material imposed on the acromion was less than the force exerted on the clavicle.

Conclusions

The findings of this study can serve as a reference to help orthopaedic surgeons select clavicle hook plates.
Literatur
1.
Zurück zum Zitat Beitzel K, Cote MP, Apostolakos J, Solovyova O, Judson CH, Ziegler CG, Edgar CM, Imhoff AB, Arciero RA, Mazzocca AD (2013) Current concepts in the treatment of acromioclavicular joint dislocations. Arthroscopy 29:387–397CrossRefPubMed Beitzel K, Cote MP, Apostolakos J, Solovyova O, Judson CH, Ziegler CG, Edgar CM, Imhoff AB, Arciero RA, Mazzocca AD (2013) Current concepts in the treatment of acromioclavicular joint dislocations. Arthroscopy 29:387–397CrossRefPubMed
2.
Zurück zum Zitat Flinkkilä T, Ristiniemi J, Hyvönen P, Hämäläinen M (2002) Surgical treatment of unstable fractures of the distal clavicle: a comparative study of Kirschner wire and clavicular hook plate fixation. Acta Orthop 73:50–53CrossRef Flinkkilä T, Ristiniemi J, Hyvönen P, Hämäläinen M (2002) Surgical treatment of unstable fractures of the distal clavicle: a comparative study of Kirschner wire and clavicular hook plate fixation. Acta Orthop 73:50–53CrossRef
3.
Zurück zum Zitat Lee YS, Lau MJ, Tseng YC, Chen WC, Kao HY, Wei JD (2009) Comparison of the efficacy of hook plate versus tension band wire in the treatment of unstable fractures of the distal clavicle. Int Orthop 33:1401–1405PubMedCentralCrossRefPubMed Lee YS, Lau MJ, Tseng YC, Chen WC, Kao HY, Wei JD (2009) Comparison of the efficacy of hook plate versus tension band wire in the treatment of unstable fractures of the distal clavicle. Int Orthop 33:1401–1405PubMedCentralCrossRefPubMed
4.
Zurück zum Zitat Haidar SG, Krishnan KM, Deshmukh SC (2006) Hook plate fixation for type II fractures of the lateral end of the clavicle. J Shoulder Elbow Surg 15:419–423CrossRefPubMed Haidar SG, Krishnan KM, Deshmukh SC (2006) Hook plate fixation for type II fractures of the lateral end of the clavicle. J Shoulder Elbow Surg 15:419–423CrossRefPubMed
5.
Zurück zum Zitat Charity R, Haidar S, Ghosh S, Tillu A (2006) Fixation failure of the clavicular hook plate: a report of three cases. J Orthop Surg 14:333–335 Charity R, Haidar S, Ghosh S, Tillu A (2006) Fixation failure of the clavicular hook plate: a report of three cases. J Orthop Surg 14:333–335
6.
Zurück zum Zitat Chiang CL, Yang SW, Tsai MY, Chen CKH (2010) Acromion osteolysis and fracture after hook plate fixation for acromioclavicular joint dislocation: a case report. J Shoulder Elbow Surg 19:e13–e15CrossRefPubMed Chiang CL, Yang SW, Tsai MY, Chen CKH (2010) Acromion osteolysis and fracture after hook plate fixation for acromioclavicular joint dislocation: a case report. J Shoulder Elbow Surg 19:e13–e15CrossRefPubMed
7.
Zurück zum Zitat Gu X, Cheng B, Sun J, Tao K (2014) Arthroscopic evaluation for omalgia patients undergoing the clavicular hook plate fixation of distal clavicle fractures. J Orthop Surg Res 9:46PubMedCentralCrossRefPubMed Gu X, Cheng B, Sun J, Tao K (2014) Arthroscopic evaluation for omalgia patients undergoing the clavicular hook plate fixation of distal clavicle fractures. J Orthop Surg Res 9:46PubMedCentralCrossRefPubMed
8.
Zurück zum Zitat Kashii M, Inui H, Yamamoto K (2006) Surgical treatment of distal clavicle fractures using the clavicular hook plate. Clin Orthop Rel Res 447:158–164CrossRef Kashii M, Inui H, Yamamoto K (2006) Surgical treatment of distal clavicle fractures using the clavicular hook plate. Clin Orthop Rel Res 447:158–164CrossRef
9.
Zurück zum Zitat Renger R, Roukema G, Reurings J, Raams P, Font J, Verleisdonk E (2009) The clavicle hook plate for Neer type II lateral clavicle fractures. J Orthopc Trauma 23:570–574CrossRef Renger R, Roukema G, Reurings J, Raams P, Font J, Verleisdonk E (2009) The clavicle hook plate for Neer type II lateral clavicle fractures. J Orthopc Trauma 23:570–574CrossRef
10.
Zurück zum Zitat Nadarajah R, Mahaluxmivala J, Amin A, Goodier D (2005) Clavicular hook–plate: complications of retaining the implant. Injury 36:681–683CrossRefPubMed Nadarajah R, Mahaluxmivala J, Amin A, Goodier D (2005) Clavicular hook–plate: complications of retaining the implant. Injury 36:681–683CrossRefPubMed
11.
Zurück zum Zitat Muramatsu K, Shigetomi M, Matsunaga T, Murata Y, Taguchi T (2007) Use of the AO hook-plate for treatment of unstable fractures of the distal clavicle. Arch Orthop Trauma Surg 127:191–194CrossRefPubMed Muramatsu K, Shigetomi M, Matsunaga T, Murata Y, Taguchi T (2007) Use of the AO hook-plate for treatment of unstable fractures of the distal clavicle. Arch Orthop Trauma Surg 127:191–194CrossRefPubMed
12.
Zurück zum Zitat Flinkkilä T, Ristiniemi J, Lakovaara M, Hyvönen P, Leppilahti J (2006) Hook-plate fixation of unstable lateral clavicle fractures: a report on 63 patients. Acta Orthop 77:644–649CrossRefPubMed Flinkkilä T, Ristiniemi J, Lakovaara M, Hyvönen P, Leppilahti J (2006) Hook-plate fixation of unstable lateral clavicle fractures: a report on 63 patients. Acta Orthop 77:644–649CrossRefPubMed
13.
Zurück zum Zitat Sanders R, Haidukewych GJ, Milne T, Dennis J, Latta LL (2002) Minimal versus maximal plate fixation techniques of the ulna: the biomechanical effect of number of screws and plate length. J Orthop Trauma 16:166–171CrossRefPubMed Sanders R, Haidukewych GJ, Milne T, Dennis J, Latta LL (2002) Minimal versus maximal plate fixation techniques of the ulna: the biomechanical effect of number of screws and plate length. J Orthop Trauma 16:166–171CrossRefPubMed
14.
Zurück zum Zitat Rozbruch RS, Müller U, Gautier E, Ganz R (1998) The evolution of femoral shaft plating technique. Clin Orthop Rel Res 354:195–208CrossRef Rozbruch RS, Müller U, Gautier E, Ganz R (1998) The evolution of femoral shaft plating technique. Clin Orthop Rel Res 354:195–208CrossRef
15.
Zurück zum Zitat Huang HL, Tsai MT, Lin DJ, Chien CS, Hsu JT (2010) A new method to evaluate the elastic modulus of cortical bone by using a combined computed tomography and finite element approach. Comput Biol Med 40:464–468CrossRefPubMed Huang HL, Tsai MT, Lin DJ, Chien CS, Hsu JT (2010) A new method to evaluate the elastic modulus of cortical bone by using a combined computed tomography and finite element approach. Comput Biol Med 40:464–468CrossRefPubMed
16.
Zurück zum Zitat Hsu JT, Fuh LJ, Lin DJ, Shen YW, Huang HL (2009) Bone strain and interfacial sliding analyses of platform switching and implant diameter on an immediately loaded implant: experimental and three-dimensional finite element analyses. J Periodontol 80:1125–1132CrossRefPubMed Hsu JT, Fuh LJ, Lin DJ, Shen YW, Huang HL (2009) Bone strain and interfacial sliding analyses of platform switching and implant diameter on an immediately loaded implant: experimental and three-dimensional finite element analyses. J Periodontol 80:1125–1132CrossRefPubMed
17.
Zurück zum Zitat Hsu JT, Tsai MT, Chang CH, Fuh LJ, Lai KA, Liu ZL, Tu MG, Huang HL (2008) Finite element analysis of the effects of sizes of acetabular components on the initial stability of the acetabular cup. J Med Biol Eng 28:59–63 Hsu JT, Tsai MT, Chang CH, Fuh LJ, Lai KA, Liu ZL, Tu MG, Huang HL (2008) Finite element analysis of the effects of sizes of acetabular components on the initial stability of the acetabular cup. J Med Biol Eng 28:59–63
18.
Zurück zum Zitat Su KC, Chuang SF, Ng EYK, Chang CH (2014) Evaluation of dentinal fluid flow behaviours: a fluid–structure interaction simulation. Comput Methods Biomech Biomed Eng 17:1716–1726CrossRef Su KC, Chuang SF, Ng EYK, Chang CH (2014) Evaluation of dentinal fluid flow behaviours: a fluid–structure interaction simulation. Comput Methods Biomech Biomed Eng 17:1716–1726CrossRef
19.
Zurück zum Zitat Su KC, Chuang SF, Ng EYK, Chang CH (2014) An investigation of dentinal fluid flow in dental pulp during food mastication: simulation of fluid–structure interaction. Biomech Model Mechan 13:527–535CrossRef Su KC, Chuang SF, Ng EYK, Chang CH (2014) An investigation of dentinal fluid flow in dental pulp during food mastication: simulation of fluid–structure interaction. Biomech Model Mechan 13:527–535CrossRef
20.
Zurück zum Zitat Sakai R, Matsuura T, Tanaka K, Uchida K, Nakao M, Mabuchi K (2014) Comparison of internal fixations for distal clavicular fractures based on loading tests and finite element analyses. Sci World J 2014:817321 Sakai R, Matsuura T, Tanaka K, Uchida K, Nakao M, Mabuchi K (2014) Comparison of internal fixations for distal clavicular fractures based on loading tests and finite element analyses. Sci World J 2014:817321
21.
Zurück zum Zitat Cronskär M, Rasmussen J, Tinnsten M (2015) Combined finite element and multibody musculoskeletal investigation of a fractured clavicle with reconstruction plate. Comput Methods Biomech Biomed Eng 18:740–748CrossRef Cronskär M, Rasmussen J, Tinnsten M (2015) Combined finite element and multibody musculoskeletal investigation of a fractured clavicle with reconstruction plate. Comput Methods Biomech Biomed Eng 18:740–748CrossRef
22.
Zurück zum Zitat Chen DW, Lin CL, Hu CC, Wu JW, Lee MS (2012) Finite element analysis of different repair methods of Vancouver B1 periprosthetic fractures after total hip arthroplasty. Injury 43:1061–1065CrossRefPubMed Chen DW, Lin CL, Hu CC, Wu JW, Lee MS (2012) Finite element analysis of different repair methods of Vancouver B1 periprosthetic fractures after total hip arthroplasty. Injury 43:1061–1065CrossRefPubMed
Metadaten
Titel
Biomechanical analysis of acromioclavicular joint dislocation treated with clavicle hook plates in different lengths
verfasst von
Cheng-Min Shih
Kui-Chou Huang
Chien-Chou Pan
Cheng-Hung Lee
Kuo-Chih Su
Publikationsdatum
01.11.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
International Orthopaedics / Ausgabe 11/2015
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-015-2890-8

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