A Modified Single-Endobutton Technique Combined with Nice Knot for Treatment of Rockwood Type III Acromioclavicular Joint Dislocation

Abstract

Purpose: Double-endobutton technique, as a widely accepted strategy for the treatment of acromioclavicular joint dislocation , is undergoing constant improvement. This study was to assess the clinical effect of a modified single-endobutton combined with nice knot in the fixation of Rockwood type III acromioclavicular joint dislocation.Methods: From January 2016 to January 2018, 16 adult patients (13 males and 3 females) with Rockwood type III acromioclavicular joint dislocation were treated with a modified single-endobutton technique combined with nice knot in our department. The age ranged from 18 to 64 years old with an average of 32.8 years old. Operative time and intraoperative blood loss were recorded, post-operative clinical outcomes and radiographic results were recorded and analyzed. Preoperative and last follow up scores in the Constant-Murley Scale, Neer score, Rating Scale of the American Shoulder and Elbow Surgeons and VAS scale and complications such as infection, re-dislocation, implant loosening, medical origin fracture and hardware pain were recorded and evaluated. Results: 16 patients were followed up for 6 to 18 months with an average of 10.3 months. The operative time was 50-90 minutes with an average of (62.5±3.10) min. The intraoperative blood loss was 30-100 ml, with an average of (55.0±4.28) ml. The complications, such as wound infection, internal fixation failure and fractures, were not found in these cases. According to Karlsson criteria, there were excellent in 14 cases, good in 2 cases at the final follow up. The mean VAS score of the patients was 5.88±0.26 preoperatively, compared with 0.19±0.14 at the final follow-up evaluation. The difference was statistically significant (P<0.01). The mean Constant score was 45.5±2.0 preoperatively, compared to 94.0±0.73 at the final follow-up evaluation. The difference was statistically significant (P<0.01). Conclusion: Nice knot provides a reliable fixation for the single-Endobutton technique in the treatment of acromioclavicular dislocations. The modified single-Endobutton technique combined with nice knot can achieve good clinical outcomes in treatment of Rockwood type III acromioclavicular joint dislocation.