Result of Wolter Plate Fixation for the Treatment of Dislocation of Acromioclavicular Joint and Clinical Importance of Coracoclavicular Ligament Repair

Objective: To explore the treatment of TOSSY type III acromioclavicular joint dislocation with clavicular hook plate combined with coracoclavicular ligament repair and its clinical effect.Methods: 80 patients with TOSSY type III acromioclavicular joint dislocation who were admitted to our hospital from January 2014 to January 2019 were selected. They were randomly divided into the control group (n = 39, treated with clavicular hook plate) and the observation group (n = 41, treated with clavicular hook plate combined with coracoclavicular ligament repair) by the random number table method. The clinical efficacy in 12 months after operation, related clinical indicators, 12-month postoperative recovery and postoperative complications were compared between the two groups.Results: The excellent and good rate was 92.68% (38/41) in 12 months after operation in the observation group, which was higher than that (76.92%, 30/39) in the control group (p < .05). There were no significant differences in the duration of surgery, intraoperative blood loss and HLOS between the observation group and the control group (p > .05). In 12 months after operation, abduction activity and forward flexion activity of the observation group were higher than those of the control group, and visual analogue score (VAS) was lower than that of the control group (p < .05). The incidence of complications in the observation group was slightly lower than that in the control group, but there was no statistically significant difference between the two groups (p > .05).Conclusions: For TOSSY type III acromioclavicular joint dislocation, clavicular hook plate combined with coracoclavicular ligament repair has a good clinical efficacy. It can improve shoulder joint function, alleviate shoulder pain and have fewer complications. It can provide a reference for clinical treatment of this type of acromioclavicular joint dislocation.

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Comparison between hook plate fixation with and without coracoclavicular ligament suture for acute acromioclavicular joint dislocations

Journal of Orthopaedic Surgery ◽

10.1177/2309499020905058 ◽

2020 ◽

Vol 28 (1) ◽

pp. 230949902090505

Author(s):

Joong-Bae Seo ◽

Seong-Jun Kim ◽

Hee-Jung Ham ◽

Jae-Sung Yoo

Keyword(s):

Clinical Outcomes ◽

Acromioclavicular Joint ◽

Plate Fixation ◽

Implant Removal ◽

Hook Plate ◽

Ligament Repair ◽

Significant Difference ◽

Patient Groups ◽

Repair Group

Background: Hook plates are widely used for repair of acromioclavicular joint (ACJ) dislocations. However, it is unclear whether repair of torn coracoclavicular (CC) ligament is necessary. The purpose of this study was to evaluate the outcomes of the hook plate fixation with direct CC ligament repair for acute ACJ dislocation in comparison with the hook plate fixation without direct CC ligament repair. Methods: The study included 120 patients with acute ACJ dislocations who underwent surgery. The patients were divided into 73 patient groups with Arbeitsgemeinschaft für Osteosynthesefragen (AO) hook plate fixation and direct CC ligament repair and 47 patient groups without direct CC ligament repair. For clinical assessments, the American Shoulder and Elbow Surgeons score, constant score, and time for implant removal were recorded. The corcoclavicular distance (CCD) and the CCD ratio were used for the evaluation of reduction. Typical reported complications, such as secondary dislocation, implant failure or loosening, peri-implant fracture, acromion osteolysis, and postoperative ACJ arthrosis, were also analyzed. Results: There were no differences in the clinical outcomes between the two groups. There was no difference in the timing of implant removal between the two groups. The last follow-up CCD was not statistically significant between group with direct CC ligament repair and without repair (9.1 ± 3.3 vs. 9.0 ± 2.8, respectively, p > 0.05). The last follow-up CCD ratio showed significant differences between the two groups (12.6 ± 25.5% vs. 26.3 ± 39.7, respectively, p < 0.05). There was no statistically significant difference in the complication rate between the two groups. Conclusion: The hook plate fixation with direct CC ligament repair group was better for maintenance of reduction than that of the hook plate fixation without direct CC ligament repair group. Although, there were no differences of clinical outcomes and complications between two groups. Level of Evidence: Level III, Retrospective Study.

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Comparison between Trans-articular and Subacromial Stabilization with Ligament Repair for Acute Acromioclavicular Dislocation

The Open Orthopaedics Journal ◽

10.2174/1874325002014010008 ◽

2020 ◽

Vol 14 (1) ◽

pp. 8-14

Author(s):

Noboru Matsumura ◽

Yusuke Kawano ◽

Ryogo Furuhata ◽

Hiroo Kimura ◽

Taku Suzuki ◽

...

Keyword(s):

Acromioclavicular Joint ◽

Treatment Options ◽

Clinical Results ◽

Acromioclavicular Joint Dislocation ◽

Coracoclavicular Ligament ◽

Acromioclavicular Dislocation ◽

Ligament Repair ◽

Distance Ratio ◽

Joint Dislocation ◽

Coracoclavicular Distance

Background: Although numerous treatment options for acromioclavicular joint dislocation have been reported, the treatment strategy is not yet standardized. Objective: The purpose of this study was to evaluate the clinical and radiographic results of coracoclavicular ligament repair with temporary acromioclavicular stabilization using suture anchors and Kirschner wires, and to compare the results between temporary trans-articular fixation and subacromial stabilization of the acromioclavicular joint. Methods: Thirty-three cases with displaced acromioclavicular joint dislocation were retrospectively evaluated. In the first 14 cases, the wires temporarily penetrated the joint for an average of 7 weeks (trans-articular group), while the acromioclavicular joint was temporarily stabilized by wires passing under the acromion that were inserted into the distal clavicle for an average of 13 weeks in the latter 19 cases (subacromial group). Clinical and radiographic results were evaluated and compared between the two groups. Results: The average UCLA score was 32.0 points in the trans-articular group and 32.8 points in the subacromial group, indicating no difference between the two groups (P = 0.418). Coracoclavicular distance ratio after surgery was significantly smaller in the subacromial group (P ≤ 0.035), and acromioclavicular dislocation ratio after removal of the wires was also smaller in the subacromial group (P ≤ 0.001) compared with the trans-articular group. Conclusion: This study revealed that coracoclavicular ligament repair with temporary acromioclavicular stabilization leads to favorable clinical results, with the subacromial group showing better maintenance of joint reduction compared with the trans-articular group. Subacromial wire stabilization is a viable option for long-term temporary fixation of acute displaced acromioclavicular joint dislocation.

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