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

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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.

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Acknowledgements

The authors acknowledge the United States National Library of Medicine (NLM) and the Visible Human Project as the source of the image data used to create the finite element analysis model in this study. The first two authors have contributed equally to this work.

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Author notes

    Authors and Affiliations

    1. Department of Orthopedics, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Taichung, Taiwan, 40705, Taiwan

      Li-Kun Hung, Wen-Hsien Lu & Cheng-Hung Lee

    2. Department of Orthopedics, Chiayi Branch, Taichung Veterans General Hospital, Chiayi, Taiwan

      Li-Kun Hung

    3. Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan

      Kuo‐Chih Su

    4. Department of Biomedical Engineering, Hung Kuang University, Taichung, Taiwan

      Kuo‐Chih Su

    5. Department of Orthopedics, Feng-Yuan Hospital, Taichung, Taiwan

      Wen-Hsien Lu

    6. Department of Marine Biotechnology and Resources, National Sun Yat-sen University, Kaohsiung, Taiwan

      Wen-Hsien Lu

    7. Department of Biotechnology, Hung Kuang University, Taichung, Taiwan

      Cheng-Hung Lee

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    1. Li-Kun Hung
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    Corresponding author

    Correspondence to Cheng-Hung Lee.

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    The authors declare that they have no conflict of interest.

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    This article does not contain any studies with human participants or animals performed by any of the authors.

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    Informed consent was obtained from all individual participants included in the study.

    Additional information

    Li-Kun Hung and Kuo‐Chih Su contributed equally to this work.

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    Hung, LK., Su, K., Lu, WH. et al. Biomechanical analysis of clavicle hook plate implantation with different hook angles in the acromioclavicular joint. International Orthopaedics (SICOT) 41, 1663–1669 (2017). https://doi.org/10.1007/s00264-016-3384-z

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    • DOI: https://doi.org/10.1007/s00264-016-3384-z

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