Long-term results of the surgical treatment of type III acromioclavicular dislocations

Abstract

The purpose of this study was to review the long-term outcomes of a previously reported prospective series of 46 type III acromioclavicular dislocations. These were treated surgically with temporary fixation of the acromioclavicular joint with wires, repair of the acromioclavicular ligaments, and overlapped suture of the deltoid and trapezius muscles. Of the 46 patients, one had died, four could not be traced, and three declined to return for follow-up, leaving 38 patients in the study. There were 36 men and two women, with a mean age at follow-up of 57.3 years (41 to 71). The mean follow-up was 24.2 years (21 to 26). Patients were evaluated using the Imatani and University of California, Los Angeles (UCLA) scoring systems. Their subjective status was assessed using the Disabilities of the Arm, Shoulder and Hand and Simple Shoulder Test questionnaires, and a visual analogue scale for patient satisfaction. The examination included radiographs of the shoulder. At a follow-up of 21 years, the results were satisfactory in 35 (92.1%) patients and unsatisfactory in three (7.9%). In total, 35 patients (92.1%) reported no pain, one slight pain, and two moderate pain. All except two patients had a full range of shoulder movement compared with the opposite side. Unsatisfactory results were the result of early redisplacement in two patients, and osteoarthritis without redisplacement in one. According to the Imatani and UCLA scores, there was no difference between the operated shoulder and the opposite shoulder (p > 0.05). Given the same situation, 35 (92.1%) patients would opt for the same surgical treatment again. Operative treatment of type III acromioclavicular joint injuries produces satisfactory long-term results.

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

“…14) Many literatures reported that satisfactory outcomes may be achieved with the use of K-wires. 4,5,16) The authors also did not find any problems with achieving ACJ stabilization by the K-wire transfixation technique. Functional outcomes were satisfactory, and the technique still seems to be a simple with low hardware's costs.…”

“…14) ACJ fixation technique is a relatively simple surgical option with good outcome reports. 11,[14][15][16] For ACJ fixation, various types of devices are used.…”

“…27) But ideal management of type III injuries is still controversial. 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.…”

Outcome After Arthroscopic Reconstruction of the Coracoclavicular Ligaments Using a Double-Bundle Coracoid Cerclage Technique

“…4 AC joint separation is a common injury among young athletes and motorcycle riders. 9 With 1 exception, all of the patients included in our study were young military men in their 20s. Eleven of the patients were injured during sports activity and one in a motorcycle accident.…”

Biomechanical properties of repairs for dislocated AC joints using suture button systems with integrated tendon augmentation

“…''overall gold standard'' [8,13,14]. Therefore, biomechanical evaluation of the newer techniques may still contribute to the improvement of current procedures.…”