Analysis of long-term results of surgical treatment of acromioclavicular dislocation

Background. Acromioclavicular dislocation is a fairly common traumatic injury of the musculoskeletal system, and according to different authors varies from 2 to 26.1 % dislocations of other localizations, and is about 10 % of all acute injuries of the shoulder girdle, taking 3rd place after dislocations of shoulder and forearm. The social significance of this damage is determined by the occurrence mainly among young working-age men. The work was aimed to identify factors that cause unsatisfactory anatomical and functional results after surgical treatment of acromioclavicular dislocations. Materials and methods. This retrospective study (2015–2020) included 93 patients who had surgical intervention for acromioclavicular dislocation. Surgical stabilization of the acromial end of the clavicle was done by Hook Plate and by Weber technic. Results. The outcome of research shows that 49.5 % of cases had good results, 31.2 % — satisfactory, and 19.3 % — poor. There is a direct correlation between unsatisfying outcome and increased severity of the injury. The study found that 9.7 % of unsatisfying results were associated while using Weber’s technic in the Tossy II, while in Tossy III, it was 27.0 %. A similar correlation was found while using Hook Platе, in the case of Tossy II, unsatisfying results were in 15.8 % of cases and Tossy III — 29.4 %. Conclusions. The reason for the unsatisfying results of the surgical acromioclavicular dislocations treatment is the severity of damage and the absence of an algorithm for diagnosis and management of this injury. In Tossy III dislocations, the use of stabilization methods as Weber’s technic, Hook Plate, or suturing damaged acromioclavicular ligaments did not demonstrate satisfying effectiveness.

Suture Augmentation of Acromioclavicular and Coracoclavicular Ligament Reconstruction for Acute Acromioclavicular Dislocation

PurposeThe objective of this report was to introduce a new suture augmentation of coracoclavicular and acromioclavicular ligament reconstruction for acute Rockwood grade III to V acromioclavicular dislocations.MethodsFrom January 2015 to January 2019, 43 patients with Rockwood III to VI acute acromioclavicular dislocations were retrospective reviewed. The outcome evaluations included coracoclavicular space, loss of reduction, and acromioclavicular space. The Disabilities of the Arm, Shoulder, and Hand questionnaire was used to assess the limb function. Clinical evaluation of patients was performed using the University of California-Los Angeles scoring systems. For comparison, another series of 28 patients treated with double Endobutton technique from January 2011 to December 2014 was reviewed. A P<0.05 was considered statistical significance.ResultsThe mean follow-up period of the two series were 39.69±7.42 months (range, 24–54 months) and37.86±8.23 months (range, 26–48 months) (P>0.05), respectively. There were significant differences regarding coracoclavicular space (11.62±2.54 mm vs 16.78±5.53 mm; P<0.05), coracoclavicular reduction loss (5.56±4.73 mm vs 26.25±4.42 mm; P<0.05), and acromioclavicular space (6.89±1.87 mm vs 7.95±2.37 mm; P<0.05). There were significant differences regarding the Disabilities of the Arm, Shoulder, and Hand questionnaire (3.3±2.8 vs 5.32±4.37; P<0.05) and University of California-Los Angeles Shoulder rating scale (31.19±2.48 vs 29.24±2.48; P<0.05). The excellent to good percentages were 100 % (n=32) and 85% (n=23), respectively. ConclusionsIn conclusion, the suture augmentation of acromioclavicular and coracoclavicular ligament reconstruction is reliable technique for acute acromioclavicular dislocation with minimal complications.Type of study/level of evidenceTherapeutic IIa.