COMPARISON OF FUNCTIONAL AND RADIOLOGICAL OUTCOMES OF HOOK PLATE AND ENDO BUTTON TECHNIQUES IN ACROMIOCLAVICULAR JOINT DISLOCATION

Abstract

Objective: To compare the functional and radiological outcomes of hook plate fixation and EndoButton stabilization in the surgical management of acute acromioclavicular (1) joint dislocation. Methods: This Quasi Experimental study was conducted in the Department of Orthopaedic Surgery at AIMC/Jinnah Hospital, Lahore over a period of three months. A total of 80 patients aged 18–60 years with acute Rockwood type III–VI acromioclavicular joint dislocations were enrolled through consecutive non-probability sampling. Patients were allocated into two equal groups. Group A underwent hook plate fixation, while Group B was treated with the EndoButton technique. Functional outcomes were assessed using the Constant-Murley Score, Disabilities of the Arm, Shoulder and Hand (DASH) Score, and Visual Analogue Scale (VAS) for pain. Radiological outcomes were evaluated by measuring maintenance of anatomical reduction and coracoclavicular distance on postoperative radiographs. Postoperative complications were also recorded. Data were analyzed using SPSS version 26.0, and a p-value of <0.05 was considered statistically significant. Results: Eighty patients completed the three-month follow-up, with 40 patients in each treatment group. Baseline demographic and clinical characteristics were comparable between the groups (p>0.05). The hook plate group had a significantly shorter operative time (71.5 ± 10.4 vs. 82.3 ± 12.8 minutes; p<0.001), whereas the EndoButton group had significantly less intraoperative blood loss (92.7 ± 24.8 vs. 128.4 ± 30.6 mL; p<0.001). Functional outcomes were significantly better in the EndoButton group, with higher Constant-Murley scores (91.8 ± 5.9 vs. 85.6 ± 7.4; p<0.001), lower DASH scores (9.8 ± 4.5 vs. 15.9 ± 6.3; p<0.001), and lower VAS pain scores (1.5 ± 0.8 vs. 2.4 ± 1.2; p<0.001). Radiological outcomes, including maintenance of reduction and coracoclavicular distance, were comparable between the two groups (p>0.05). Implant irritation and the need for secondary surgery were significantly more frequent in the hook plate group. Conclusion: Both hook plate fixation and the EndoButton technique effectively restored radiological alignment in acute acromioclavicular joint dislocations. However, the EndoButton technique demonstrated superior functional recovery, lower postoperative pain, fewer implant-related complications, and eliminated the need for routine implant removal, making it a favorable surgical option for managing high-grade AC joint dislocations.