Treatment of Complete Acromioclavicular Dislocation: Present Indications and Surgical Technique with Biodegradable Cords

Abstract

We report a retrospective study of 48 patients with complete acromioclavicular dislocation (Tossy III). All patients (38 male; 10 female) with an average age of 33.4 years underwent surgery including PDS-augmentation. More than half of the injuries were caused by sport accidents. There were no complications during surgery. 87% of the patients were free of complaints and subjectively very satisfied with the surgical results. By radiological examination we diagnosed a subluxation of the clavicula in 25% of the cases and arthrosis in 17% of the cases. Assessment of subjective complaints, the clinical examination, and the radiological diagnostic according to the Taft Score (0-12 points) resulted in an average value of 10.2 points. The surgical intervention using PDS-cord augmentation in cases of complete acromioclavicular separation is a safe and economic method with a low complication rate. Advantages are possible early-functional treatment, no risk of movement of implants, and avoidance of metal removal.

K-wire Arthrodesis and Coracoclavicular Augmentation of Complete Acromioclavicular Separations: Functional and Subjective Results

“…Removal of the coracoclavicular PDScords are not necessary. In several cases a rejection of PDS-cords leading to wound healing disorders were described [21]. In our study no complications related to the PDS-cord occurred.…”

“…The anatomical gains of other surgical techniques varied with a loss of reduction in 20-40% of the cases [1]. As a result of isolated PDS-augmentation Moenig et al [21] diagnosed a subluxation in 25% and found arthrosis in 12% of the cases postoperatively. But by now the clinical relevance of radiological visible arthrosis remains controversial.…”

“…In literature the frequency of patients, who were free of pain after surgical treatment range between 42 and 95% [21,28]. In the metaanalysis of Phillips et al [28] 93% of surgically and 96% of conservatively treated patients had no or only little pain.…”

“…This is represented by the multiplicity of described surgical techniques in literature [5,10,12,18,21,30,31].…”

Clinical and Radiologic Outcomes of Acute Acromioclavicular Joint Dislocation: Comparison of Kirschner's Wire Transfixation and Locking Hook Plate Fixation

“…7,16) Recently, many authors recommend surgical reconstruction exclusively for young patients, in athletes or for heavy workers. 2,[28][29][30] In the current study, out of 77 cases, 8 cases (10%) were Rockwood classification type III. Although the authors chose conservative treatment for type III ACJ dislocations in most cases, operative treatment was indicated in patients with demands for greater functionality and early ROM.…”