Modified Weaver-Dunn Procedure for Type 3 Acromioclavicular Joint Dislocation: Functional and Radiological Outcomes

Galasso, Olimpio; Tarducci, Lorenzo; Benedetto, Massimo De; Orlando, Nicola; Mercurio, Michele; Gasparini, Giorgio; Castricini, Roberto

doi:10.1177/2325967120905022

Cited by 16 publications

(10 citation statements)

References 35 publications

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“…Both the WD procedure and the CCR procedure achieved satisfactory outcomes in terms of treating chronic AC dislocations [2,23,30,31]. Some studies supported the use of the WD procedure [14,15,[30][31][32] whereas others favored CCR techniques [2,5,6,23]. A meta-analysis was further conducted to compare the outcomes for the WD procedure and CCR in the treatment of chronic AC dislocations.…”

Section: Discussionmentioning

confidence: 99%

“…The original WD procedure included a lateral clavicle resection, reduction of the dislocated clavicle, and transfer of the coracoacromial ligament to the lateral clavicle without additional fixation [33]. Later, numerous studies discussed modified WD procedures using various additional fixation devices intended to provide further stability and maintain reduction of the AC joint, in which satisfactory clinical and radiological outcomes were achieved [32,[34][35][36]. One study reported that 75% of the modified WD procedures had good to excellent results [36,37].…”

Section: Discussionmentioning

confidence: 99%

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Does Weaver–Dunn procedure have a role in chronic acromioclavicular dislocations? A meta-analysis

et al. 2022

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Background In treatment of chronic acromioclavicular (AC) joint dislocations, both the Weaver–Dunn procedure (WD) and CC ligament reconstruction (CCR) are recommended options due to the low possibility of healing of the coracoclavicular (CC) ligaments. The aim of this review was to determine whether CCR will yield favorable clinical and radiographic outcomes in the treatment of chronic AC dislocations. Method The Cochrane Library, EMBASE, and PubMed databases were searched for literature on chronic AC dislocations from data inception to June 30, 2021. Patient data were pooled using standard meta-analytic approaches. The Cochrane-Mantel–Haenszel method and variance-weighted means were used to analyze the outcomes. The Review Manager version 5.3 software (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark) was used to calculate the heterogenicity, mean difference, and relative risk (RR) for all outcomes in the meta-analysis. Results The current analysis included four trials on this topic, and all AC joint dislocations were classified as Rockwood types III to VI. The pooled data showed that the CCR group had significantly better post-operative American Shoulder and Elbow Surgeons Shoulder (ASES) scores, Oxford Shoulder Scores (OSSs), and Nottingham Clavicle Scores (NCSs) than the WD group, with a significant difference (p < 0.001, p = 0.020, and p < 0.001, respectively). In terms of the post-operative Constant-Murley Scores (CMSs), there were no significant differences between the CCR group and the WD group (p = 0.100). The CCR group had significantly better post-operative abduction and flexion of the index shoulder than the WD group (p < 0.001 and p < 0.001, respectively). In terms of radiological outcomes, the post-operative coracoclavicular distance (CCD) with a 10 kg load was smaller in the CCR group compared to that in the WD group (p < 0.001). The overall surgical wound infection rate was 11.6% in the WD group and 12.9% in the CCR, respectively (p = 0.82). Conclusion The CCR group had better clinical outcome scores in the ASES, OOS, NCS, abduction, flexion, and external rotation than the WD group. In terms of radiological outcomes, the CCR group showed less displacement in weight-loaded post-CCD than the WD group, which indicated that the CCR provided more stability and resistance to deformation forces.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Does Weaver–Dunn procedure have a role in chronic acromioclavicular dislocations? A meta-analysis

et al. 2022

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“…11 More than 60 techniques have been described in the literature for CC reconstruction in the setting of AC joint injuries, including many variations in the mWD. 9,12 In a systematic review focused solely on AC and CC ligament reconstruction, Moastshe et al looked at 939 patients in 34 studies. Interventions included free tendon graft, suspensory devices, synthetic ligaments, mWD, and hook plate.…”

Section: Discussionmentioning

confidence: 99%

Modified Weaver-Dunn Technique Using Transosseous Bone Tunnels and Coracoid Suture Augmentation

Patel

Hill

Casey

et al. 2021

J Am Acad Orthop Surg

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Introduction: A modified Weaver-Dunn procedure for the management of acromioclavicular joint injuries that uses transosseous bone tunnels and coracoid suture augmentation is described with associated clinical results. Methods: A retrospective review of 39 consecutive patients who underwent a primary mWD procedure by a single surgeon from January 2013 to July 2019 was conducted. Patient charts and radiographs were reviewed for clinical course, complications and management, and radiographic evaluation. Satisfaction, American Shoulder and Elbow Surgeons (ASES), Single Assessment Numeric Evaluation, and Simple Shoulder Test scores were obtained. Results: A total of 28 patients (72%) with a mean follow-up of 37.5 (12 to 84 months) and a mean age of 44.3 6 15.1 years were included. Postoperative ASES, Simple Shoulder Test, Single Assessment Numeric Evaluation, and satisfaction scores were 90.6 6 14.2, 11.1 6 1.5, 87.3 6 10.2, and 4.4 6 1.2 (out of 5), respectively, with a significant improvement in ASES of 42.2 6 21.8 points (P , 0.001). All patients had significant decrease in coracoclavicular distance (P , 0.001). Three patients (10.7%) had complications, with two (7.1%) requiring additional surgery. Conclusion: Excellent functional and radiographic outcomes can be achieved with this modified Weaver-Dunn technique. Complication and revision rates are comparable with those that are found in the literature. Level of Evidence: Level IV, Retrospective cohort study A cromioclavicular (AC) joint injuries are very common in all populations, especially in the young adults that engage in competitive contact sports or in laborers. AC joint injuries account for 40% of all shoulder injuries, with the most severe injuries resulting in notable loss of strength and function of the shoulder. 1,2 Over 60 procedures have been

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“…Type 3 injuries are initially treated conservatively. Surgical intervention is done if needed later on [12][13][14].…”

Section: Discussionmentioning

confidence: 99%

Anatomic reconstruction for acromioclavicular joint injuries: a pilot study of a cost-effective new technique

Pattu

Chellamuthu

Sellappan

et al. 2021

Clin Shoulder Elbow

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Background: The treatment for acromioclavicular joint injuries (ACJI) ranges from a conservative approach to extensive surgical reconstruction, and the decision on how to manage these injuries depends on the grade of acromioclavicular (AC) joint separation, resources, and skill availability. After a thorough review of the literature, the researchers adopted a simple cost-effective technique of AC joint reconstruction for acute ACJI requiring surgery.Methods: This was a prospective single-center study conducted between April 2017 and April 2018. For patients with acute ACJI more than Rockwood grade 3, the researchers performed open corococlavicular ligament reconstruction using synthetic sutures along with an Endobutton and a figure of 8 button plate. This was followed by AC ligament repair augmenting it with temporary percutaneous AC K-wires. Clinical outcomes were evaluated using the Constant Murley shoulder score. Results: Seventeen patients underwent surgery. The immediate postoperative radiograph showed an anatomical reduction of the AC joint dislocation in all patients. During follow-up, one patient developed subluxation but was asymptomatic. The mean follow-up period was 30 months (range, 24–35 months). The mean Constant score at 24 months was 95. No AC joint degeneration was noted in follow-up X-rays. The follow-up X-rays showed significant infra-clavicular calcification in 11 of the 17 patients, which was an evidence of a healed coracoclavicular ligament post-surgeryConclusions: This study presents a simple cost-effective technique with a short learning curve for anatomic reconstruction of acute ACJI. The preliminary results have been very encouraging.

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Modified Weaver-Dunn Procedure for Type 3 Acromioclavicular Joint Dislocation: Functional and Radiological Outcomes

Cited by 16 publications

References 35 publications

Does Weaver–Dunn procedure have a role in chronic acromioclavicular dislocations? A meta-analysis

Does Weaver–Dunn procedure have a role in chronic acromioclavicular dislocations? A meta-analysis

Modified Weaver-Dunn Technique Using Transosseous Bone Tunnels and Coracoid Suture Augmentation

Anatomic reconstruction for acromioclavicular joint injuries: a pilot study of a cost-effective new technique

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