medigraphic.com
Órgano Oficial del Hospital Angeles Health System

2018, Number 1

<< Back Next >>

Acta Med 2018; 16 (1)

Acromioclavicular dislocation treatment. Comparison of three different surgical techniques

Zimbrón LD, Reyes SR, Algarín RJA, Saínos SAP, Zimbrón MJB, Saucedo ME

Language: Spanish
References: 26
Page: 35-40
PDF size: 166.21 Kb.


ABSTRACT

The acromioclavicular dislocation is a common injury and represents 12% of all shoulder injuries. There are more than 60 descriptive techniques for coracoclavicular ligament complex reconstruction but a preferred technique has not been established yet. The objective of this study is to compare the postoperative functional status of the patients and the efficacy of the reduction of the three most used techniques for acromioclavicular reconstruction in our Institution (Modified Bosworth technique, acromioclavicular TightRope® system and acromioclavicular hook plate). We have evaluated 52 patients in an age range between 19 and 52 years (X̅ = 35.87) with the diagnosis of type III acromioclavicular dislocation of the Tossy-Rockwood classification that received treatment with one of the techniques mentioned that received six month follow-up as minimum, and their functional status were evaluated with the DASH score. The statistical analysis was realized with the Kruskal-Wallis test for the comparison of independent means in small samples (p = 0.033) and then make the verification with the Mann Whitney and Bonferron comparison test. According to our results there is a functional positive difference for acromioclavicular TightRope® system (p = 0.013 IC = 95%) versus p = 0.127 of modified Bosworth with acromioclavicular hook plate and p = 0.152 of modified Bosworth with acromioclavicular TightRope® System.


REFERENCES

  1. Fraser-Moodie JA, Shortt NL, Robinson CM. Injuries to the acromioclavicular. J Bone Joint Surg Br. 2008; 90 (6): 697-707.

  2. Fukuda K, Craig EV, An KN, Cofield RH, Chao EY. Biomechanical study of the ligamentous system of the acromioclavicular joint. J Bone Joint Surg Am.1986; 68 (3): 434-440.

  3. Tossy JD, Mead NC, Sigmond HM. Acromioclavicular separations: useful and practical classification for treatment. Clin Orthop Relat Res. 1963; 28: 111-119.

  4. Rockwood CA, Williams G, Young D. Disorders of the acromioclavicular joint. In: Rockwood CA, Matsen FA, eds. The shoulder. Second ed. Vol. 1. Philadelphia: WB Saunders, 1998, pp. 483-553.

  5. Modi CS, Beazley J, Zywiel MG, Lawrence TM, Veillette CJ. Controversies relating to the management of acromioclavicular joint dislocations. Bone Joint J. 2013; 95-B (12): 1595-1602.

  6. Lizaur A, Sanz-Reig J, Gonzalez-Parreño S. Long-term results of the surgical treatment of type III acromioclavicular dislocations. J Bone Joint Surg Br. 2011; 93 (8): 1088-1092.

  7. Smith TO, Chester R, Pearse EO, Hing CB. Operative versus non-operative management following Rockwood grade III acromioclavicular separation: A meta-analysis of the current evidence base. J Orthop Traumatol. 2011; 12 (81): 19-27.

  8. Gstettner C, Tauber M, Hitzl W, Resch H. Rockwood type III acromioclavicular dislocation: surgical versus conservative treatment. J Shoulder Elbow Surg. 2008; 17 (2): 220-225.

  9. Spencer HT, Hsu L, Sodl J, Arianjam A, Yian EH. Radiographic failure and rates of re-operation after acromioclavicular joint reconstruction. Bone Joint J. 2016; 98-B (4): 512-518.

  10. Thomas K, Litsky A, Jones G, Bishop JY. Biomechanical comparison of coracoclavicular reconstructive techniques. Am J Sports Med. 2011; 39 (4): 804-810.

  11. Mazzocca AD, Santangelo SA, Johnson ST, Rios CG, Dumonski ML, Arciero RA. A biomechanical evaluation of an anatomical coracoclavicular ligament reconstruction. Am J Sports Med. 2006; 34 (2): 236-246.

  12. Lee SJ, Nicholas SJ, Akizuki KH, McHugh MP, Kremenic IJ, Ben-Avi S. Reconstruction of the coracoclavicular ligaments with tendon grafts: A comparative biomechanical study. Am J Sports Med. 2003; 31 (5): 648-655.

  13. Beaver AB, Parks BG, Hinton RY. Biomechanical analysis of distal clavicle excision with acromioclavicular joint reconstruction. Am J Sports Med. 2013; 41: 1684-1688.

  14. Milewski MD, Tompkins M, Giugale JM, Carson EW, Miller MD, Diduch DR. Complications related to anatomic reconstruction of the coracoclavicular ligaments. Am J Sports Med. 2012; 40: 1628-1634.

  15. Bosworth BM. Acromioclavicular separation: New method of repair. Surg Gynecol Obstet. 1941; 73: 866-871.

  16. Sastre S, Peidro L, Ballesteros JR, Combalia A. Manejo quirúrgico de la inestabilidad acromioclavicular aguda. Revista Española de Artroscopia y Cirugía Articular. 2015; 22 (1): 33-37.

  17. Balser D. Eine neue Methode zur operativen Behandlung der akromioklavikulären luxation. Chir Prax. 1976; 24: 275.

  18. Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand). The Upper Extremity Collaborative Group (UECG). Am J Ind Med. 1996; 29 (6): 602-608.

  19. Rosales RS, Delgado EB, Díez de la Lastra Bosch I. Evaluation of the Spanish version of the DASH and carpal tunnel syndrome health-related quality-of-life instruments: cross-cultural adaptation process and reliability. J Hand Surg Am. 2002; 27 (2): 334-343.

  20. Hervása MT, Navarro MJ, Peiro S, Rodrigo PJ, López MP, Martínez TI. Versión española del cuestionario DASH. Adaptación transcultural, fiabilidad, validez y sensibilidad a los cambios. Med Clin (Barc). 2006; 127 (12): 441-447.

  21. Algarín RJ, Salcedo DJ, Rodríguez OJ, Bello GA, Sancho BF. Luxaciones acromioclavicular grado III con técnica mínimamente invasiva. Acta Ortop Mex. 2010; 24 (5): 317-323.

  22. Beitzel K, Cote MP, Apostolakos J, Solovyova O, Judson CH, Ziegler CG et al. Current concepts in the treatment of acromioclavicular joint dislocations. Arthroscopy. 2013; 29 (2): 387-397.

  23. Wolf EM, Pennington WT. Arthroscopic reconstruction for acromioclavicular joint dislocation. Arthroscopy. 2001; 17 (5): 558-563.

  24. Hackenberger J, Schmidt J, Altmann T. The effects of hook plates on the subacromial space-a clinical and mrt study. Eur J Trauma Emerg Surg. 2009; 142 (5): 603-610.

  25. Folwaczny EK, Yakisan D, Sturmer KM. The Balser plate with ligament suture. A dependable method of stabilizing the acromioclavicular joint. Unfallchirurg. 2000; 103 (9): 731-740.

  26. Bathis H, Tingart M, Bouillon B, Tiling T. The status of therapy of acromioclavicular joint injury. Results of a survey of trauma surgery clinics in Germany. Der Unfallchirurg. 2001; 104 (10): 955-960.




2020     |     www.medigraphic.com