Abstract
Purpose
While Clavicle hook plates have demonstrated favorable results regarding bone and shoulder function, their design can potentially lead to complications due to pressure concentration at the plate's tip. This study aims to investigate the impact of different hook implantation angles on the contact surface area between the hook plate and acromion, with the goal of minimizing mismatch and maximizing contact surface area.
Methods
Twenty soft shoulder cadavers were included in the study, and the contact surface area of the hook plate was measured in different positions based on the hook implantation angle.
Results
The results showed variations in compatibility, width, and length of the contact surface area depending on the hook implantation angle and the medial or lateral row placement. The lateral row generally demonstrated superior compatibility (84.0% vs 46.67%, p-value < 0.001), with a broader contact area (3.55 ± 0.08 mm vs 3.09 ± 0.10 mm, p-value = 0.004) and a longer contact area (7.36 ± 0.19 mm vs 5.10 ± 0.23 mm, p-value < 0.001) at specific angles. A detailed analysis of the lateral position revealed that the zero angle of implantation resulted in the greatest contact surface area, measuring 3.91 ± 0.70 mm in width (p value = 0.083) and 8.85 ± 1.24 mm in length (p value < 0.001).
Conclusion
Placing the hook laterally and at the zero position according to the hook implantation angle can maximize contact surface area, may reduce stress concentration, and minimize complications in hook plate fixation. Further research and consideration of anatomical variations are warranted to refine the placement technique and enhance patient outcomes.
Level of Evidence
Level V evidence.
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Acknowledgements
We would like to thank Jaruwat W. and Noppadol P. for his assistance and guidance in this research.
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Contributions
Pamok S. and Thanawan.J performed the dissections, identification and measurements, including repeated mensuration with different intervals to increase intra- and inter-observer reliability. Peerapong P. and Vajarin P. were involved in planning and supervised the work. Pamok S. processed the experimental data, performed the analysis, drafted the manuscript and designed the figures. Rosarin R. prepared the samples including cadaver preservation, sectioning, choosing the qualified cadaver and also with the crucial step of planning sequences to perform this cadaveric study. Chumnan I. aided in interpreting the results and worked on the manuscript. All authors discussed the results commented and final approved on the manuscript.
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This research was conducted without external funding, and the authors affirm that they have no conflicts of interest.
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Ethical approval to perform and report this study was obtained from institutional review board, police general hospital. All procedures performed in studies were in compliance with the principles outlined in the Declaration of Helsinki, the Belmont report, subsequent amendments, or equivalent ethical standards.
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Saengsirinavin, P., Iamsirikulmit, C., Piyapittayanun, P. et al. Optimizing hook implantation angle of the clavicular hook plate: a cadaveric study. Eur J Orthop Surg Traumatol (2024). https://doi.org/10.1007/s00590-024-03981-z
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DOI: https://doi.org/10.1007/s00590-024-03981-z