Comparison of the efficacy of hook plate versus pinning in treatment of acute acromioclavicular joint dislocation

Objective: Type III acromioclavicular joint dislocation is treated by various methods including hook plate, pinning and fixiation by a screw. Each of these methods have their own advantages and disadvantages. This study was designed to compare the efficacy of hook plate and pinning methods in the treatment of type III acute acromioclavicular joint dislocation. Methodology: In this study, 50 patients with type III acute acromioclavicular joint dislocation aged 20 to 40 years old who referred to Emam Khomeini and Razi Hospital of Ahvaz Iran, between the years of 1998 and 2010 were enrolled. Twenty patients were treated with pinning and 30 patients were treated with hook plate method. All the patients were hospitalized for 24 hours after surgery and were followed up one year after surgery. Data was collected by acquiring an x-ray and completing a questionnaire. Results: The pins of the patients in the pinning group were removed using local anesthesia. In the hook plate group, the patients underwent another surgery to remove their plate. No further dislocation was reported in any patients. However, subluxation was seen in 25% of the pinning group and 23.3% of the hook -plate group. The mean surgery time was 35 minutes in the pinning and 45 minutes in the hook plate group and the amount of bleeding was estimated to be 70 and 100 respectively. Only one case of superficial infection was seen in the hook plate group. Also one of the pinning group patients and 10 hook plate patients complained of pain during activity. Conclusion: The pinning method had relatively less complications such as pain, post surgical infection and bleeding and the surgery time was shorter. Also the costs were lower and no further surgery was needed to remove the instruments. Therefore, it seems that pinning method was more suitable than hook plate method.