Study On Prevention Of Subacromial Impingement Syndrome By Improvement Of Clavicular Hook Plate And Development Of Related Instruments

Objective: To explore the relationship between the appearance of the acromion impingement sign after clavicular hook plate operation and the difference between the hook end depth and acromion height of the hook plate used,and to provide references for clinical diagnosis and treatment of acromioclavicular joint dislocation.Prevention of postoperative subacromial impingement syndrome(SIS).At the same time,we have designed an instrument that can measure the height of the acromion during the operation to help the surgeon choose the type of hook plate reasonably during the operation.Methods: Patients with SIS from March 2018 to June 2020 were selected as the experimental group and asymptomatic patients postoperatively,as the control group.From March 2018 to June 2020,a total of 170 patients met the inclusion criteria: 34 with SIS were considered the experimental group and 136 without SIS,the control group.The experimental group comprised 23 men and 11 women,with an average age of21.647±6.440(range,19–48)years: 10 on the left and 24 on the right.The control group consisted of 85 men and 51 women,with an average age of 34.140±9.139(range,21–54)years: 55 on the left and 81 on the right.CT was used to measure the height of acromion on coronal plane before operation.The hook end depth and acromial height of the hook plate used in patients were recorded,and the difference between them was calculated.Results: No significant difference in sex,age,or position was observed between the two groups(P >0.05),so they can be compared.The height of the shoulders of the experimental group and the control group were not statistically different(t=0.545,P=0.587).The difference between the hook plate depth and acromial height was7.500±1.912 mm and 6.563±1.537 mm in the experimental and control groups,respectively,with statistically significant difference(t=3.021,P=0.006).Finally,univariate analysis was carried out with different values of >5.5 mm,>6.0 mm,>6.5 mm,>7 mm,>8mm,>9 mm,and >10 mm as grouping indices.No significant difference was observed in values of >5.5 mm(t = 7.446,P = 0.060).Other groups showed statistically significant differences.Conclusions: The occurrence of SIS after placing the clavicular hook plate may be related to the difference between its depth and the acromial height.A difference of >6 mm may be a factor affecting the occurrence of SIS.Using CT to measure the height of the acromion before the operation can provide suggestions for the selection of the hook plate model during the operation.However,due to the existence of CT bone artifacts and cartilage,the data of the acromion may have errors.We use the acromion measurer for clinical use,Looking forward to the follow-up results of these patients.