Publication:

Surgical approaches and postoperative outcomes in acromioclavicular joint fractures: a retrospective study of patient demographics, effectiveness and plate removal timing

Background Acromioclavicular (AC) joint fractures and dislocations are common shoulder injuries, particularly among young active males. Despite the widespread use of various fixation techniques, optimal management and implant removal timing remain topics of ongoing debate. This study retrospectively evaluates patient demographics, surgical approaches, postoperative outcomes, and plate removal timing among individuals treated for AC joint fractures at a major trauma center.

Methods A retrospective observational study was conducted at Rashid Hospital, Dubai, including 187 patients aged ≥18 years who underwent operative or conservative management for AC joint fractures between 2018 and 2025. Sociodemographic data, treatment modality, surgical technique, complications, functional outcomes, and implant removal times were extracted from electronic medical records. Descriptive statistics were performed using SPSS v29.

Results The cohort was predominantly male (93%), with most patients aged ≤40 years (69%). Hook plates were the primary fixation method (86.6%). Postoperatively, 47.8% reported pain, while 52.2% remained pain-free. Range-of-motion limitations were noted in 45.2% of patients, with adduction deficits being most common. Reoperation was primarily for implant removal, occurred in 79.7% of cases. Most plate removals occurred between 4–6 months, peaking at 5 months (41 cases). Early removal at 3 months was uncommon, and 37 patients had no removal at the time of review.

Conclusions Hook plate fixation remains the predominant surgical approach for AC joint fractures at our institution, with generally favorable postoperative outcomes. Functional recovery was preserved in over half of the patients, and implant removal most occurred within 4–6 months. These findings highlight the importance of timely postoperative evaluation and individualized decision-making regarding plate removal to optimize long-term outcomes.