Abstract
Aim: A comparison of two different techniques of acro-mioclavicular joint reduction in complete AC disruption.
Methods: During 1992–2001, 59 patients (50 male; 9 female; average 32.3y), underwent surgical reconstruction for complete (Allman-Tossy III) AC dislocation. Fixation of the joint was achieved in all patients by double-banded coracoclavicular stabilization, using heavy nonabsorbable sutures in a double-banded ligamentous substitution manner. In 35 patients (group I) a temporary acromioclavicular fixation was done (with K-W, removable at 6th postoperative week), whereas in the rest 24 patients (group II) an additional fixation of the acromioclavicular disruption, with nonabsorbable sutures, without using K-W was performed.
Results: Mean follow-up period was 6.4 years. Our results according to Constant-Murley score were excellent or very good in 25 patients (71.4%) of group I and 21 (87.5%) patients of group II. Loss of reduction (3), calcification (5) and superficial pin infection (2) were noted with greater frequency in patients of group I. Three of them reoperated because of K-W migration or breakage. Complications of group II included 1 superficial infection, 1 calcification with restriction of joint motion and 1 case with slight loss of reduction.
Conclusions: Reduction of the acromioclavicular joint in association with adequate retention of the coracoclavicular joint are the cornerstones for a good surgical result. Double banded coracoclavicular fixation and acromio-clavicular repair with heavy nonabsorbable sutures and no use of K-W, seems to be the best surgical technique provided adequate stabilization of acromioclavicular joint, preservation of clavicular rotation, no risk of implant migration and no need of material removal.
The abstracts were prepared by Eleni Koutsoukou. Correspondence should be addressed to him at the Hellenic Association of Orthopaedic Surgery and Traumatology (HAOST), 20, A. Fleming str, 15123 Marousi, Athens, Greece.
