Acromioclavicular Joint Fixation Using an Acroplate Combined With a Coracoclavicular Screw

Abstract

BackgroundAppropriate treatment of acromioclavicular joint dislocation is controversial. Acroplate fixation is one of the most common treatment methods of acromioclavicular joint (ACJ) dislocation. Based on the risk of re-dislocation after Acroplate fixation, we assumed that combined fixation with an Acroplate and a coracoclavicular screw helps improve the outcome.ObjectivesThe main purpose of the current study was to compare the outcome of ACJ dislocation treated with an Acroplate alone and in combination with coracoclavicular screw.Patients and MethodsThis study was carried out on 40 patients with ACJ dislocation types III to VI who were divided randomly into two equal groups: Acroplate group (P) and Acroplate in combination with coracoclavicular screw group (P + S). The screws were extracted 3-6 months postoperatively. The patients were followed for 1 year and Imatani’s score was calculated. Finally, the data were compared between the groups.ResultsThe mean Imatani’s score was significantly higher in P + S group (83.4 ± 14.1) than P group (81.2 ± 10.3) (P < 0.001). The mean duration of surgery was the same in the two groups (59.8 ± 9.4 minutes in group P V.s 64.3 ± 10.9 minutes in group P + S; P = 0.169). There were no cases of re-dislocation, degenerative changes and ossification and all patients returned to their previous jobs or sporting activities.ConclusionsUsing a coracoclavicular screw combined with an Acroplate can improve the patients’ function after ACJ disruption without any significant increase in surgical duration. Authors recommend this technique in the fixation of ACJ dislocation.

Comparison of Effectiveness and Safety in Treating Acute Acromioclavicular Joint Dislocation with Five Different Surgical Procedures: A Systematic Review and Network Meta‐Analysis

“…Since Rockwood's classification of ACJ is based on the degree and direction of clavicle displacement, reconstruction of the CC ligament is the most commonly applied clinical surgical strategy 3,4 . Although Bosworth screws have been reported in the literature in addition to the five surgical procedures included in this study, after a careful review of the literature we found that few studies met the criteria and no valid data were available 55–57 . Notably, in addition to CC reconstruction, AC reconstruction (tension band wires, Kirschner wires, or sutures), 8,58 AC and CC reconstruction (Weaver–Dunn procedures) 59 are also options for surgical treatment.…”

“… 3 , 4 Although Bosworth screws have been reported in the literature in addition to the five surgical procedures included in this study, after a careful review of the literature we found that few studies met the criteria and no valid data were available. 55 , 56 , 57 Notably, in addition to CC reconstruction, AC reconstruction (tension band wires, Kirschner wires, or sutures), 8 , 58 AC and CC reconstruction (Weaver–Dunn procedures) 59 are also options for surgical treatment. However, the literature on AC reconstruction is scarce and valid data are not available.…”