No abstract

Background Treatment options of acromioclavicular (AC) joint dislocation depend on the injury severity and the functional demand of the patient. Common surgical options include fixation across the AC joint, coracoclavicular (CC) fixation, and AC joint or CC reconstruction. However, the clinical superiority of these various procedures is controversial. This study aimed to compare the clinical and radiological outcomes of loop suspensory reconstruction and hook plate fixation for acute unstable AC joint dislocation.Methods We retrospectively included patients with acute unstable AC joint dislocation who were treated with loop suspensory reconstruction (group I, 23 cases) or hook plate fixation (group II, 14 cases) in our hospital from January 2010 to December 2016 with a minimum follow-up period of 1 year after surgery. We assessed the clinical outcomes of blood loss during surgery, surgical duration, duration of medication required for pain relief after the primary operation, occurrence of complications, and the Constant-Murley score; radiological analysis included postoperative arthritic change and the CC distance discrepancy ratio (CCDR) on preoperative and final follow-up plain films.Results The average follow-up duration was17.0±6.1 months. The mean duration of pain-control medication usage was 121.7±174.1 and 235.4±251.8 days in groups I and II, respectively, significantly lower in the CC reconstruction group (p=0.031). Group I revealed a superior Constant-Murley score at the final outpatient follow-up as compared with group II (71.7±15.8 vs 61.1±6.7, p=0.009). Regarding radiographic analysis, the hook plate group had a superior residual CCDR (group I vs II = 30% vs 80±40%, p<0.001). In addition, there were 9 cases of subluxation noted in group I and 2 cases in group II; however, 4 cases of acromion osteolysis were observed in group II.Conclusions The principle finding of the present study was that hook plate fixation was superior to loop suspensory reconstruction in terms of CC distance maintenance. However, the loop suspensory reconstruction group demonstrated superior clinical functional outcomes and less painkiller usage. A further randomized controlled trial with a long-term follow-up period is required.