Evaluation of three-dimensional in vivo scapular kinematics and scapulohumeral rhythm between shoulders with a clavicle hook plate and contralateral healthy shoulders
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Acromioclavicular-coracoclavicular ligament injury occurs frequently, and the clavicle hook plate technique is an easy-to-use treatment method. However, complications such as subacromial impingement syndrome, synovitis, erosion, osteolysis, post-operative pain, and post-operative limitations in range of motion have been reported. We aimed to evaluate the use of the clavicle hook plate in the shoulder joints and to compare in vivo three-dimensional (3D) scapular kinematics and scapulohumeral rhythm between the shoulders with a clavicle hook plate and contralateral normal shoulder joints.
Ten male patients (aged 40.5 ± 14.4 years) who underwent clavicle hook plate fixation for an acromioclavicular-coracoclavicular ligament injury were selected. Computed tomography and fluoroscopy were conducted on both the shoulder joints, and 3D models were created. Using a 3D-2D model-image registration technique, we determined the 3D coordinates of the scapula, and we measured the scapular kinematics and scapulohumeral rhythm.
The values for upward rotation, posterior tilt, and external rotation in the two groups increased in proportion with humeral elevation, showing significant differences between the two groups (p < 0.05). Overall, the value in the clavicle hook plate group (group H) was smaller than that in the control group (group C) by 23.5% (6.7°) of upward rotation and 64.8% (18.9°) of posterior tilt. However, the external rotation in group H was greater than that in group C by 32.3% (2.3°). In overall value, there was a significant difference not in upward rotation and external rotation, but in posterior tilt. During humeral elevation, the overall changes in scapulohumeral rhythm were 4.65 ± 2.45 in group H and 3.8 ± 0.8 in group C, and statistical differences were not detected between the two groups.
Clavicle hook plate fixation changes the scapular kinematics and scapulohumeral rhythm; thus, when clavicle hook plate fixation is complete, the implant should be promptly removed.
KeywordsScapular kinematics Scapulohumeral rhythm Clavicle hook plate 3D/2D model-image registration technique
This work was supported by the Ministry of Education of the Republic of Korea and the National Research Foundation of Korea (NRF-2015S1A5B8036349).
Compliance with ethical standards
This study was approved by the Ethics Committee and the Institutional Review Board of the Wonju College of Medicine, Yonsei University (YWMR-15-8-072). All patients gave written consent after the study was explained to them.
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