Combination of Clavicular Hook Plate with Coracoacromial Ligament Transposition in Treatment of Acromioclavicular Joint Dislocation

Abstract

Objective: To evaluate the clinical efficacy of Arbeitsgemeinschaft für Osteosynthesefragen (AO) clavicular hook plate (CHP) combined with coracoacromial ligament transposition for Rockwood III-V dislocation of AC joint, providing an alternative choice for AC joint dislocation treatment.Methods: Twenty-five patients diagnosed with Rockwood III-V dislocation of acromioclavicular (AC) joint, including 18 males and seven females, aged 43.5 AE 2.4 years old on average, who had undergone open reduction and AO CHP in combination with coracoacromial (CC) ligament transposition between January 2010 and December 2015, were retrospectively analyzed. Among them, 17 cases were diagnosed as type III, five cases were type IV, and three cases were type V. The surgery mainly included three main steps: bone flap incision, drilling in the clavicle, and hook plate fixation and AC joint reposition. The treatment efficacy was evaluated through clinical examinations and imaging studies for the shoulder joint, including gross observation and measuring coracoid clavicle distance (CC-Dist) using orthophoria X-ray before and 1 year after the surgery, and University of California (UCLA) shoulder rating scale.Results: All the patients were followed up three to four times in 18 months (12-24 months) on average, and the UCLA rating results showed that there were 17 excellent cases (68%), five good cases (20%), and three fair cases (12%). The CC-Dist values after the surgery reduced to 9.7 AE 0.7 mm, which was significantly (P < 0.05) lower compared to that before the surgery (15.8 AE 1.6 mm). Most (88%) of the cases showed almost normal joint function and good anatomical arrangement of the acromioclavicular joint, without any secondary dislocation, and for them, 12 AE 2 weeks on average were needed to regain the normal function of shoulder joint movement. Conclusion:Due to the stable fixation, fewer complications, and satisfactory therapeutic effect with great clinical value, the combination of AO CHP and CC ligament transposition is expected to be used for treating Rockwood III-V dislocation of AC joint.

Double Fixation Technique for Acute Acromioclavicular Joint Dislocation Using the Two-Button Technique and Gracilis Autograft Reinforcement: A Case Report of an Elite Athlete Seeking a Rapid Return to Sports Activity

“…The mean recovery time for these patients was 12 weeks. The recommended plate removal is around three to four months postoperatively to prevent wear on the acromion and facilitate better healing of traumatized surrounding tissues [ 13 ]. To enhance both vertical and horizontal stability, some authors have advocated for a multiple all-suture anchor technique reconstruction of the coracoclavicular ligament, which provides three vertical stabilizers compared to the single stabilizer in the classic TightRope/endobutton technique [ 14 ].…”

Treatment of acromioclavicular dislocations with a concomitant coracoid fracture: a systematic review of 37 patients

“…One might argue that surgical procedures have changed throughout the years and may result in different outcomes. Recent articles on sole AC dislocations still show good anatomical and functional results after treatment with a hook plate, 32,39 while new anatomical reconstruction techniques are gaining popularity and show promising results. 13,15,23 Nonetheless, we decided to include older articles as well to provide a complete summary of the current available literature since the available data on this combined injury are limited.…”

Clinical and Instrumental Diagnosis of Dislocations of the Clavicle Acromial End

“…У структурі гострих травматичних пошкоджень у ділянці плечового поясу частка вивихів АКК становить більше 12%. Ці пошкодження частіше діагностують у чоловіків найбільш працездатного віку (від 30 до 40 років) та у спортсменів, які займаються контактними видами спорту [1][2][3].…”