Rockwood type III acute acromioclavicular dislocations:14 years of experience comparing direct anatomic repair and percutaneous coracoclavicular screw
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Yasser M. Assaghir
- چاپ و سال / کشور: 2010
Description
Background The management of grade III acute acromioclavicular dislocations is controversial. We hypothesized that direct repair of acromiocalvicular and coracoclavicular injured structures should yield better functional results than percutaneous stabilization of the clavicle to the coracoid without any capsulo-ligamento-muscular repair. Methods Twenty-six patients in two matched groups with Rockwood type III acute acromioclavicular dislocations followed for a mean of 99.3 months were evaluated. Group- 1 was treated by closed reduction, and group-2 was treated by direct repair of clavicular muscle attachments, coracoclavicular and acromioclavicular ligaments. A coracoclavicular 4.5-mm cortical screw inserted in a lag fashion was used in both groups for 45 days. Radiographic analysis, function according to American Shoulder and Elbow Surgeons Score (ASES), and the ability to return to previous work were used for evaluation. Results At the Wnal follow-up, ASES in group-1 was 91.2 (SD 4.5) points (83–98), while it was 92.7 (SD 4.2) points (87–100) in group-2, and this was statistically signiWcant (P = 0.010). Reduction was maintained with no statistically signiWcant diVerence of coracoclavicular distance on the injured and the healthy sides in both groups. All patients returned to their previous work. Conclusion Although the anatomic intra-articular and extra-articular repair yields better functional results than percutaneous screw Wxation in grade III acromioclavicular dislocations, percutaneous screw Wxation with its shorter operative time, minimally invasive nature, shorter rehabilitation and earlier return to work sounds like the better choice.
Eur J Orthop Surg Traumatol (2011) 21:87–93 DOI 10.1007/s00590-010-0676-7 Received: 15 April 2010 / Accepted: 24 June 2010 / Published online: 15 July 2010
