Comparative evaluation of hook plate and tension band wiring in the management of acromioclavicular dislocation: a retrospective study

Background: The acromioclavicular (AC) joint is located between the lateral end of the clavicle and the medial part of the acromion. The joint capsule is reinforced by a strong system of ligaments, and there is a fibrocartilaginous disc between the two bony surfaces. The AC joint dislocation (ACD) is a fairly common shoulder girdle injury, which is seen in about 9–12% of active adults. The aim of this study was to perform a comparative descriptive evaluation of two commonly used surgical techniques – tension band wiring (TBW) and hook plate (HP) fixation – for the treatment of acute AC dislocations (Rockwood types III–V), focusing on functional recovery, radiological outcomes, and complication profiles rather than demonstrating the superiority of one technique over the other. Patients and methods: A retrospective comparative study was conducted at our hospital between 2022 and 2024. The study included patients with acute AC dislocation (within 2 weeks after injury) who were regularly monitored for at least 6 months. Results: All 34 patients were able to return to their pre-surgical occupation. The total operative time was shorter in the TBW group, with no statistical significance. The time during which the operated arm was supported with a sling was shorter in the HP group (around 2–4 weeks), which was statistically significant ( P -value = 0.0001). No significant decrease in ROM was observed in the affected side at the last follow-up in all patients. The functional results were measured using the Constant score. Conclusion: Both methods used in our study are adequate options for the management of acute AC dislocation, and while they differ in surgical technique, they are comparable in functional and clinical outcomes. While the TBW is a cheaper alternative, we found that the HP group had fewer complications and allowed early full range of motion, always keeping in mind the removal of the plate within 3 months to prevent osteolysis and subacromial irritation.