BACKGROUND: In the present study, we aimed to compare clinical and radiographic outcomes between hook plate fixation and coracoclavicular (CC) ligament reconstruction for the treatment of acute unstable acromioclavicular (AC) joint dislocation. METHODS: Forty-two patients who underwent surgery for an unstable acute dislocation of the AC joint were included. We divided them into two groups according to the treatment modality: internal fixation with a hook plate (group I, 24 cases) or CC ligament reconstruction (group II, 18 cases). We evaluated the clinical outcomes using a visual analog scale (VAS) for pain and Constant-Murley score, and assessed the radiographic outcomes based on the reduction and loss of CC distance on preoperative, postoperative, and final follow-up plain radiographs. RESULTS: The mean VAS scores at the final follow-up were 1.6 +/- 1.5 and 1.3 +/- 1.3 in groups I and II, respectively, which were not significantly different. The mean Constant-Murley scores were 90.2 +/- 9.9 and 89.2 +/- 3.5 in groups I and II, respectively, which were also not significantly different. The AC joints were well reduced in both groups, whereas CC distance improved from a mean of 215.7% +/- 50.9% preoperatively to 106.1% +/- 10.2% at the final follow-up in group I, and from 239.9% +/- 59.2% preoperatively to 133.6% +/- 36.7% at the final follow-up in group II. The improvement in group I was significantly superior to that in group II (p < 0.001). Furthermore, subluxation was not observed in any case in group I, but was noted in six cases (33%) in group II. Erosions of the acromion undersurface were observed in 9 cases in group I. CONCLUSIONS: In cases of acute unstable AC joint dislocation, hook plate fixation and CC ligament reconstruction yield comparable satisfactory clinical outcomes. However, radiographic outcomes based on the maintenance of reduction indicate that hook plate fixation is a better treatment option.
Acromioclavicular Joint/injuries/radiography/*surgery ; Acute Disease ; Adult ; Arthroscopy ; Bone Plates ; Dislocations/radiography/*surgery ; Female ; Humans ; Ligaments, Articular/surgery ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo observe the clinical effects of clavicular hook plate combined with suture anchor in treating type Tossy III chronic acromioclavicular dislocation.

METHODSFrom January 2008 to December 2012,18 patients with type Tossy III chronic acromioclavicular dislocation were treated with clavicular hook plate and suture anchor. There were 12 males and 6 females, aged from 20 to 56 years old with an average of 31.5 years. Ten cases were left dislocation and 8 cases were right dislocation. Operation time was 3 weeks to 4 months after injury with a mean of 1.8 months. Functional exercise was adopted 2 weeks after operation. And Karlsson standard was used to evaluate curative effect.

RESULTSAll patients were followed up for 6 to 24 months with an average of 16 months. According to Karlsson standard, 17 cases were excellent and 1 was poor.

CONCLUSIONClavicular hook plate combined with suture anchor can repair conoid ligament and trapezoid ligament in treating type Tossy III chronic acromioclavicular dislocation, and had advantages of simple operation, less trauma, stable fixation, it can obtain satisfactory effects.

Acromioclavicular Joint ; diagnostic imaging ; injuries ; surgery ; Adult ; Bone Plates ; Female ; Follow-Up Studies ; Humans ; Joint Dislocations ; diagnostic imaging ; surgery ; Male ; Middle Aged ; Radiography ; Suture Anchors ; Treatment Outcome ; Young Adult

OBJECTIVETo compare therapeutic effects between Kirschner tension band fixation (TBF) and clavicular hook-plate (CHP) for treating acromioclavicular dislocations of Allman Grade III.

METHODSFrom Jan. 1995 to Dec. 2007, a total of 39 patients who were diagnosed as acromioclavicular joint dislocation of Grade III were treated with Kirschner tension band fixation (TBF 18 patients, 12 patients were male, 6 patients were female, mean age were (27.50 +/- 12.76) years old, average fixation duration were (4.28 +/- 1.27) months) and clavicular hook plate fixation (CHP 21 patients, 18 patients were male, 3 patients were female, mean age were (34.76 +/- 12.39) years old, average fixation during were (8.29 +/- 1.49) months). All the patients were followed up with a mean period over 4 years. The therapeutic effects of the two groups were compared base on complications, Karlsson scores and re-subluxation.

RESULTSThe average period from injury to fixation removal was (4.28 +/- 1.27) and (8.29 +/- 1.49) months in TBF and CHP groups respectively, comparison between the two groups, t = -8.951, P < 0.01, there was statistical difference, and the course of disease in TBF group was shorter than that of CHP group. Five patients in TBF group and 1 patient in CHP group had complications (P = 0.077 > 0.05), as well as 3 patients in TBF group and 1 patient in CHP group had re-subluxation (P = 0.318 > 0.05). Karlsson evaluation results:in TBF group, 15 patients got a grade A result, 3 grade B and 0 grade C; and in CHP groups above data was 20, 1 and 0 respectively (P = 0.530 > 0.05). There was no statistical differences between the two groups in evaluation outcomes.

CONCLUSIONThe two fixation methods are all effective methods to treat Grade III acromioclavicular dislocation of Grade III, and the long-term outcome is satisfactory.

Acromioclavicular Joint ; diagnostic imaging ; injuries ; surgery ; Adolescent ; Adult ; Aged ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Postoperative Complications ; Radiography ; Shoulder Dislocation ; diagnostic imaging ; etiology ; surgery ; therapy ; Treatment Outcome ; Young Adult