Evaluation of the Surgical Treatment of Acromioclavicular Joint Dislocation With a New Option for Temporary Fixation of the Acromioclavicular Joint

The purpose of this paper is to evaluate the results of surgical treatment of acute acromioclavicular joint (ACJ) dislocation using coracoclavicular cerclage, coracoacromial ligament transfer to the distal third of the clavicle, and a new option for strengthening the temporary stabilization of the ACJ using a Kirschner wire between the clavicle and scapula. We evaluated 21 patients who underwent surgical treatment for ACJ dislocation. The average follow-up period was 18 months and varied from 13 to 23 months. Postoperative results, graded by the UCLA scoring system, were satisfactory in 20 patients. Using radiographic evaluation, 18 patients did not show loss of reduction. Among 21 patients who underwent surgical treatment, only 2 complications related to a new method of temporary ACJ stabilization were reported, neither of which appeared to influence the final outcome. The authors concluded that the surgical treatment of acute ACJ dislocation provides good functional and radiographic outcomes and that a new method of temporary ACJ stabilization described herein is an easy-to-perform and low-cost procedure with a low complication rate.

[1]  D. Swank,et al.  Hook plate fixation of acute displaced lateral clavicle fractures: mid-term results and a brief literature overview , 2012, Journal of Orthopaedic Surgery and Research.

[2]  A. Rokito,et al.  Current concepts in the surgical management of acromioclavicular joint injuries. , 2012, Bulletin of the NYU hospital for joint diseases.

[3]  João Baptista Gomes dos Santos,et al.  Estudo transversal sobre o tratamento das lesões acrômioclaviculares agudas , 2009 .

[4]  W. Mutschler,et al.  Consistency of long-term outcome of acute Rockwood grade III acromioclavicular joint separations after K-wire transfixation. , 2009, The Journal of trauma.

[5]  Sang-Jin Shin,et al.  Coracoclavicular Ligament Reconstruction for Acromioclavicular Dislocation Using 2 Suture Anchors and Coracoacromial Ligament Transfer , 2009, The American journal of sports medicine.

[6]  David N. Collins,et al.  Disorders of the Acromioclavicular Joint , 2009 .

[7]  M. A. Rocha,et al.  Evolução funcional nas fraturas da extremidade proximal do fêmur , 2009 .

[8]  P. Allen,et al.  Results using the AO hook plate for dislocations of the acromioclavicular joint , 2008, Expert review of medical devices.

[9]  L. Catalano,et al.  Coracoclavicular stabilization using a suture anchor technique. , 2008, American journal of orthopedics.

[10]  K. Cho,et al.  Minimally Invasive Coracoclavicular Stabilization with Suture Anchors for Acute Acromioclavicular Dislocation , 2008, The American journal of sports medicine.

[11]  G. Bain,et al.  Clinical results of coracoacromial ligament transfer in acromioclavicular dislocations: A review of published literature , 2008, International journal of shoulder surgery.

[12]  Chunyan Jiang,et al.  Proximally based conjoined tendon transfer for coracoclavicular reconstruction in the treatment of acromioclavicular dislocation. , 2007, The Journal of bone and joint surgery. American volume.

[13]  M. Waseem,et al.  Clavicular hook plate: complications of retaining the implant. , 2006, Injury.

[14]  E. Tillett,et al.  A biomechanical comparison of Bosworth and poly-L lactic acid bioabsorbable screws for treatment of acromioclavicular separations. , 2005, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[15]  Patrick Jost,et al.  Prevalence and Variance of Shoulder Injuries in Elite Collegiate Football Players , 2005, The American journal of sports medicine.

[16]  Robert D Mehrberg,et al.  Disorders of the acromioclavicular joint. , 2004, Physical medicine and rehabilitation clinics of North America.

[17]  R. Warren,et al.  Shoulder Injuries to Quarterbacks in the National Football League , 2004, The American journal of sports medicine.

[18]  J. Iannotti,et al.  Operative treatment of acromioclavicular joint injuries and results. , 2003, Clinics in sports medicine.

[19]  E. Tolo,et al.  Complications of the treatment of the acromioclavicular and sternoclavicular joint injuries, including instability. , 2003, Clinics in sports medicine.

[20]  G. Paletta,et al.  Complications of treatment of acromioclavicular and sternoclavicular joint injuries. , 2003, Clinics in sports medicine.

[21]  M. Busse,et al.  Normalwerte der Schulterkraft in Abhängigkeit von Alter und Geschlecht - Vergleich zum Constant-, UCLA-, ASES-Score und SF-36 Fragebogen , 2003 .

[22]  M. Busse,et al.  [Normal values of the shoulder strength in dependency on age and gender--comparison with the constant, UCLA, ASES scores and SF36 health survey]. , 2003, Zeitschrift fur Orthopadie und ihre Grenzgebiete.

[23]  T. Schlegel,et al.  A Prospective Evaluation of Untreated Acute Grade III Acromioclavicular Separations , 2001, The American journal of sports medicine.

[24]  M. Tingart,et al.  [The status of therapy of acromioclavicular joint injury. Results of a survey of trauma surgery clinics in Germany]. , 2001, Der Unfallchirurg.

[25]  A. Pavlik,et al.  Surgical treatment of chronic acromioclavicular joint dislocation by modified Weaver-Dunn procedure , 2001, Knee Surgery, Sports Traumatology, Arthroscopy.

[26]  M. Tingart,et al.  [Conservative or surgical therapy of acromioclavicular joint injury--what is reliable? A systematic analysis of the literature using "evidence-based medicine" criteria]. , 2000, Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen.

[27]  J. Zuckerman,et al.  Complications of treatment of complete acromioclavicular joint dislocations. , 2000, Instructional course lectures.

[28]  A. M. Phillips,et al.  Acromioclavicular Dislocation: Conservative or Surgical Therapy , 1998, Clinical orthopaedics and related research.

[29]  M. Wirth,et al.  Reconstruction of Chronic and Complete Dislocations of the Acromioclavicular Joint , 1998, Clinical orthopaedics and related research.

[30]  M. Lemos.  The Evaluation and Treatment of the Injured Acromioclavicular Joint in Athletes , 1998, The American journal of sports medicine.

[31]  G. Nuber,et al.  Acromioclavicular Joint Injuries and Distal Clavicle Fractures , 1997, The Journal of the American Academy of Orthopaedic Surgeons.

[32]  T. P. Goss.  The scapula: coracoid, acromial, and avulsion fractures. , 1996, American journal of orthopedics.

[33]  A. Sethi,et al.  Surgical Treatment of Complete Acromioclavicular Dislocation Using the Coracoacromial Ligament and Coracoclavicular Fixation: Report of a Technique in 14 Patients , 1995, Journal of orthopaedic trauma.

[34]  C. Dumontier,et al.  Acromioclavicular dislocations: treatment by coracoacromial ligamentoplasty. , 1995, Journal of shoulder and elbow surgery.

[35]  Evan L. Flatow,et al.  Surgical Treatment of Complete Acromioclavicular Dislocations , 1994, The American journal of sports medicine.

[36]  Paul G. Moreau,et al.  Rockwood and Green’s Fractures in Adults , 1994 .

[37]  F A Lyons,et al.  Migration of pins used in operations on the shoulder. , 1990, The Journal of bone and joint surgery. American volume.

[38]  W. Wallace,et al.  The management of acute acromioclavicular dislocation. A randomised prospective controlled trial. , 1989, The Journal of bone and joint surgery. British volume.

[39]  P. Tsou.  Percutaneous cannulated screw coracoclavicular fixation for acute acromioclavicular dislocations. , 1989, Clinical orthopaedics and related research.

[40]  F. Wilson,et al.  Dislocation of the acromioclavicular joint. An end-result study. , 1987, The Journal of bone and joint surgery. American volume.

[41]  S. Vainionpää,et al.  Acute complete acromioclavicular dislocation. A prospective randomized trial of fixation with smooth or threaded Kirschner wires or cortical screw. , 1987, Annales chirurgiae et gynaecologiae.

[42]  R. Lindsey,et al.  The migration of a broken pin following fixation of the acromioclavicular joint. A case report and review of the literature. , 1986, Orthopedics.

[43]  R. Eaton,et al.  Computerized axial tomography-a method of localizing steinmann pin migration: a case report. , 1981, Orthopedics.

[44]  I. Clarke,et al.  UCLA anatomic total shoulder arthroplasty. , 1981, Clinical orthopaedics and related research.

[45]  J K Weaver,et al.  Treatment of acromioclavicular injuries, especially complete acromioclavicular separation. , 1972, The Journal of bone and joint surgery. American volume.

[46]  H. Norrell,et al.  MIGRATION OF A THREADED STEINMANN PIN FROM AN ACROMIOCLAVICULAR JOINT INTO THE SPINAL CANAL. A CASE REPORT. , 1965, The Journal of bone and joint surgery. American volume.

[47]  B. M. Bosworth.  Acromioclavicular Dislocation: End-Results of Screw Suspension Treatment. , 1948, Annals of surgery.