{
  "abstract": "Introduction: In open reduction and hook plate fixation for high-grade acromioclavicular (AC) joint dislocation, proper placement of the hook plate is crucial in preventing subacromial osteolysis and improving clinical outcomes. This study aimed to identify the optimal sagittal plane positioning of the hook plate to minimize subacromial stress and erosion.\n\nMaterials and methods: Six pairs of artificial bone models, designed to mimic human clavicle and scapula anatomy, were used to assess the biomechanical effects of three hook plate positions: anterior (group A), neutral (group N), and posterior (group P). Each model was equipped with a 5-hole clavicle hook plate secured with 3.5-mm locking screws. A pressure sensor measured contact pressures and areas under sagittal rotations. The clavicle and scapula were fixed in customized jigs, and physiological loading conditions were simulated with a preload of 20 N and a 70 N upward force on the clavicle. Clavicular rotations of 15° internal and external were applied to evaluate their effect on contact pressures.\n\nResults: Group P showed a significantly lower mean pressure (1.27 MPa) than group A (1.92 MPa, p < 0.01) and group N (1.83 MPa, p < 0.01). Maximum pressure in group P (1.37 MPa) was also significantly lower than in group A (2.75 MPa, p < 0.01) and group N (2.34 MPa, p < 0.01). The contact area was smallest in group P (11.00 mm2) compared to group A (19.00 mm2, p < 0.01) and group N (17.00 mm2, p < 0.01). Clavicular rotations significantly increased subacromial pressure and contact area at all plate positions compared to the neutral position (p < 0.01).\n\nConclusion: Posterior position of the hook plate in the sagittal plane significantly reduced subacromial pressure and contact area compared to neutral or anterior positions. Additionally, internal and external rotations of the clavicle further increased subacromial stress, indicating the importance of considering clavicular movement in clinical settings. Within the biomechanical test, these findings suggest that posterior positioning of the hook plate may help attenuate subacromial stress and could thereby have the potential to reduce the likelihood of subacromial bone erosion; however, further clinical or finite-element validation is warranted before this can be translated into a clinical recommendation for the surgical treatment of high-grade AC joint dislocations.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Orthopedic Surgery, Keimyung University Dongsan Hospital, Daegu, Republic of Korea",
    "Department of Orthopaedic Surgery, Inje University, Ilsan Paik Hospital, Goyang-si, Republic of Korea"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 2,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Jung-Min Lee"
    },
    {
      "affs": [
        1
      ],
      "name": "Jae-Hoo Lee"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/2mhr6bmfhw54t.bib",
  "cited_by": 0,
  "doi": "10.1016/j.asmart.2026.08.004",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13733321/",
  "id": "2mhr6bmfhw54t",
  "issns": [
    "2214-6873"
  ],
  "landing_url": "https://doi.org/10.1016/j.asmart.2026.08.004",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Article"
    ],
    [
      "openalex",
      "2732|Shoulder and Clavicle Injuries"
    ]
  ],
  "openalex": "W7223828282",
  "pdf_url": "https://www.sciencedirect.com/science/article/pii/S2214687326000245/pdf",
  "pmcid": "PMC13733321",
  "pmid": "42985262",
  "published": "2026-10-27",
  "publisher": "Asia-Pacific Knee, Arthroscopy and Sports Medicine Society",
  "ris": "https://research.draconitic.com/paper/2mhr6bmfhw54t.ris",
  "sources": [
    {
      "first_seen": "2026-11-08T12:23:08Z",
      "native_id": "PMC13733321",
      "source": "pmc",
      "url": "https://doi.org/10.1016/j.asmart.2026.08.004"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2732|Shoulder and Clavicle Injuries",
      "subfield": "surgery"
    }
  ],
  "title": "Biomechanical impact of sagittal plane clavicle hook plate positioning on subacromial stress",
  "title_text": "Biomechanical impact of sagittal plane clavicle hook plate positioning on subacromial stress",
  "type": "peer-reviewed",
  "updated_at": "2026-11-08T12:23:08Z",
  "url": "https://research.draconitic.com/paper/2mhr6bmfhw54t",
  "venue": "Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and Technology",
  "versions": []
}