Bifocal Stabilisation of Acute Acromioclavicular Joint Dislocation using Suture Anchor and Temporary K-Wires: A Retrospective Analysis
https://doi.org/10.5704/MOJ.2211.016
- Author:
Vijayan S
1
;
Kulkarni MS
1
;
Jain CP
1
;
Shetty S
1
;
Aroor MN
1
;
Rao SK
1
Author Information
1. Department of Orthopaedics, Kasturba Medical College Manipal - MAHE, Manipal, India
- Publication Type:Journal Article
- Keywords:
acromioclavicular joint, coracoclavicular joint, joint dislocations, open reduction, shoulder injuries
- From:Malaysian Orthopaedic Journal
2022;16(No.3):104-112
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: The acromioclavicular joint (ACJ) is a major
link connecting the upper limb to the torso. The
acromioclavicular and coracoclavicular (CC) ligaments help
in stabilising the joint. We feel it is prudent to address both
these ligament injuries, to achieve optimum result. This
study was undertaken to analyse the results of a simple frugal
surgical technique we used to deal with this injury
considering stabilisation for both these ligaments.
Materials and methods: In this retrospective study,
skeletally mature patients with Type III, IV or V ACJ
dislocations who underwent open reduction and stabilisation
of the joint with temporary K-wires, repair of the capsule and
augmentation of CC ligaments with suture anchors were
included. Clinico-radiological and functional outcome was
evaluated. Functional assessment of the upper limb was
analysed using the Disabilities of Arm, Shoulder, and Hand
Score (DASH), Constant shoulder score (CSS) and Oxford
shoulder score (OSS).
Results: Clinical and radiological evaluation of the 32
patients who had completed two years from the index
surgery, was done. Out of the 37 patients included initially,
five were lost in follow-up. Majority of the subjects included
were males and type V was the most common injury. Mean
pre-operative CC distance on the affected side was
13.92±4.94mm. In the immediate post-operative radiograph,
it was 7.63±2.08mm and in the final follow- up was
9.36±2.75mm. Measurements were taken by two
independent investigators and inter, and intra-observer
reliability were analysed by Interclass correlation
coefficient. Excellent functional outcome was noted despite
the 1.81±1.50mm average loss of correction. At final followup, mean DASH score was 4.67±4.18, Oxford shoulder score
was 44.06±2.44 and Constant shoulder score was
86.37±5.81. The severity of the injury had no significant
effect on the functional outcome post our method of
stabilisation and rehabilitation.
Conclusion: Bifocal fixation restores the multidirectional
stability of the disrupted ACJ. Adequate radiological
reduction, good functional outcome and simplicity of
execution make this technique an undemanding one for use
in regular practice.
