Management of Acromioclavicular Dislocation: Coracoclavicular Ligament Reconstruction Combined with Hook Plate Fixation v.s. Suture Anchor Fixation

  • Jianbin Sun
Keywords: Acromioclavicular dislocation; Coracoclavicular ligament reconstruction; Suture anchor; Hook plate; Internal fixation

Abstract

This study aims to investigate the efficacy of two surgical methods in treating acromioclavicular (AC) dislocation: coracoclavicular (CC) ligament reconstruction combined with hook plate fixation or with suture anchor fixation.. Follow-up visits were conducted to measure AC gap and CC gap using X ray examination; the surgical efficacy was assessed via Karlsson as well as Constant-Murley scoring systems. SPSS 13.0 software was then used to analyze the experimental data. 82 patients received a minimum of 48 months of follow-up visits, including 42 subjects in group A and 40 in group B. The patients in the two groups were comparable in terms of age, gender, injury side, and Rockwood type. X-ray examination of the AC gap and CC gap revealed the following observations: i) the two groups displayed no statistical differences at 6 months after the operation (P>0.05); ii) group A exhibited a clearly larger gap than group B at 48 months after the operation (P<0.05); and iii) both gaps measured at 48 months after the operation in group A were greater than their relevant values measured at 6 months(P<0.05). According to Constant-Murley assessment, groups A and B had average scores of 83.6 and 91.5, respectively. Based upon Karlsson score, the excellent and good rate of functional recovery in the group B was 92.5%, which was clearly superior to 81% in group A (P<0.05). The results revealed that CC ligament reconstruction combined with suture anchor fixation generated a better outcome for AC dislocation patients than CC ligament reconstruction combined with hook plate fixation. After removing the hook plate, the AC gaps and CC gaps significantly expanded, which may be related to the relatively poor outcomes.

Published
2020-05-01