Mineralization and integrity of the bone graft mass were evaluated among patients having posterolateral fusion. Grafting consisted of a composite of Grafton and "local" autologous bone (n=56) or iliac crest autograft alone (n=52). Mineralization was rated radiographically at baseline and at 3, 6, 12, and 24 months. Integrity was judged as fused or not fused. Mineralization ratings did not differ significantly between groups at any postoperative interval (P values of .25-1 .00). The percentage of patients fused was similar in both groups (60% and 56% for Grafton and controls, respectively; P=.83). Fifteen control patients reported donor site pain. These findings warrant further evaluation of this composite.

This study reports on the followup of 25 children who were thought to have complete acromioclavicular joint dislocations. The patients were from 5 to 16 years old at the time of injury. Followup ranged between one and nine years. All were treated surgically. Various methods of stabilization were used, including transfixing the acromioclavicular joint with pins or a Bosworth screw and Mersilene (Ethicon, Somerville, NJ) taping of the clavicle to the coracoid. Good or excellent results, including return to full, asymptomatic activity and essentially normal clinical and roentgenographic appearance, were seen in over 90% of the cases. None of the children developed growth disturbances. Two of the 25 developed asymptomatic acromioclavicular joint arthritis, and both were cross-pinned. Children below the age of 13 years rarely sustain a complete acromioclavicular joint dislocation, but usually sustain a fracture of the distal clavicle with an intact acromioclavicular joint. Five (20%) of 25 patients below age 13 were erroneously diagnosed as having an acromioclavicular joint lesion. These children had only a fracture of the distal clavicle with rupture of the coracoclavicular ligament complex. Children of 13 years and older usually sustained complete dislocations of the acromioclavicular joint similar to adults. In children below age 13, conservative treatment should produce good or excellent results. Patients above age 13 all had adult-type acromioclavicular joint dislocations and were, accordingly, treated as adults.