• P Hemmann, M Koch, M Gühring, C Bahrs, and P Ziegler.
• Department of Trauma and Reconstructive Surgery, BG Unfallklinik Tuebingen, Eberhard Karls University Tuebingen, Schnarrenbergstrasse 95, 72076, Tuebingen, Germany. philhemmann@gmail.com.
• Arch Orthop Trauma Surg. 2021 Apr 1; 141 (4): 603-610.

IntroductionACJ separation is a common shoulder injury. A variety of surgical techniques for high-grade ACJ separations have been described. A commonly used technique represents open reduction and fixation by a hook plate. Goal of the present study was to evaluate radiographic and functional outcome in patients with high-grade ACJ separations following surgical treatment with a hook plate before and after surgery as well as after hook plate removal.Materials And MethodsPatients undergoing surgery with a hook plate due to traumatic ACJ separation between 2012 and 2014 were included and examined during a follow-up control. Demographic and clinical data as well as radiographs pre- and postoperatively were evaluated. Additionally, range of motion, DASH Score and Constant-Murley Score (CMS) were analysed in a follow-up examination. Wilcoxon signed-rank test and Spearman's rank correlation were used for statistical analysis.Results99 patients (88 m/11 w, 44 y) were included in the present study. 69 (64 m/5 w, 49 y) could be examined during long-term follow-up (38 month). After hook plate removal, the CCD increased significantly (13.7 ± 0.9 mm) compared to the hook plate in situ (9.9 ± 0.8 mm, p = 0.000001). 68% of all patients achieved a full range of motion post-operatively. Main limitations of range of motion affected external rotation as well as ante-/retroversion. Mean DASH Score was 5.6 ± 1 points and CMS 90.0 ± 1.4 points.ConclusionIn contrast to a significant higher CCD after hook plate removal, nearly all patients achieved good to excellent functional results for DASH and CMS. This indicates that loss of reduction does not necessarily lead to poor functional outcome after ACJ separation surgery.

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