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FSA analysis of the effects of clavicular hook plate on the three-dimensional instantaneous motion of shoulder joints

#br# LI Yu1, LIU Zhi-yuan2*, WANG Jin-wu2, HU Zhi-gang3, DAI Ke-rong2   

  1. 1.School of Mechatronics Engineering, Henan University of Science and Technology, Luoyang 471003, China; 2. Department of Orthopaedics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China; 3.Medical Technology and Engineering College, Henan University of Science and Technology, Luoyang 471003, China
  • Online:2016-08-29 Published:2016-08-31
  • Supported by:

    National Key Basic Research Project, 2012CB933604, 2011CB013300; National High Technology Research and Development Program of China, “863” Program, 2015AA020308; National Natural Science Foundation of China, 81171707, 8157090044, 81560356; Project of Shanghai Municipal Science and Technology Commission, 14DZ1941102, 15dz1942104; Joint Research Project of Major Diseases of Health System in Shanghai, 2013ZYJB0501; Important Weak Discipline Construction Project of Health and Family Planning System in Shanghai, 2015ZB0404; Shanghai Municipal Education Commission—Gaofeng Clinical Medicine Grant Support, 20152224; Innovation Fund of Translational Medicine, Shanghai Jiao Tong University School of Medicine

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Abstract:

Objective · To explore the effects of clavicular hook plate on the three-dimensional instantaneous motion of shoulder joints after clavicular fracture operation. Methods · Three patients with clavicle fracture who underwent clavicular hook plate fixation were enrolled. A flat type fluoroscopic imaging system and spiral CT were used and a 3D reconstruction model of the clavicle and hook plate was built via thin layer CT. The local coordinate system was established according to anatomical landmarks of the clavicle. The clavicular hook plate and the local coordinate system were matched on X ray images of the clavicle at different postures captured by the fluoroscopic imaging system. The 3D motion resulted from the interaction of the clavicular hook plate and the clavicle under physiological load was simulated by the computer. The displacement and rotation values of the clavicular hook plate and the clavicle at three axis directions were measured for different postures according to the 3D coordinate system established based on the plate and the clavicle. The effects of clavicular hook plate on the motion of shoulder joints after fracture healing were analyzed. Results · The clavicular hook plate affected both abduction, intorsion and extorsion of shoulder joints. In this study, the clavicular hook plate and the clavicle had a rotation angle similar to the rotation angle of the clavicle in normal people (27°) and a larger forward displacement (average 6.8 mm) of distal clavicle as compared with normal people (5.1 mm). The average abduction angle in patients was 84.79°. Conclusion · Patients with the clavicular hook plate should remove the internal fixation timely 3-6 months after surgery in order to avoid the subacromial impingement syndrome.

Key words: fracture of clavicle, clavicular hook plate, 2D-3D matching