Modified closed‑loop double‑endobutton technique for repair of rockwood type III acromioclavicular dislocation

Abstract

Acromioclavicular dislocation (ACD) is a common injury. According to the Rockwood classification, ACD is classified into six types (type I–VI); however, for type III injuries, it remains controversial whether or not operative treatment should be applied. Numerous studies have advocated early surgical treatment to ensure early rehabilitation activities. Thus, the present study aimed to investigate a modified closed-loop double-endobutton technique (MCDT), that may be used to repair Rockwood type III ACD. In the current study, 61 patients with Rockwood type III ACD were enrolled during a period of 5 years at the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University. Patients were divided into three groups according to the surgical method used, the MCDT group (n=20), the common closed-loop double-endobutton technique (CCDT) group (n=21), and the clavicular hook plate fixation (CHPF) group (n=20). Preoperative and intraoperative information were recorded. Furthermore, the functional scores of injured shoulder were evaluated prior to surgery and following surgery with a 1-year follow-up. Among the three groups, postoperative functional scores were significantly more improved compared with those prior to surgery (P<0.05), and no significant difference was observed regarding the coracoclavicular interval with the 1-year follow-up (P>0.05). Postoperative functional scores in the MCDT and CCDT groups were significantly more improved compared those in the CHPF group (P<0.05). In addition, the duration of surgery in the MCDT group was significantly shorter compared with that in the CCDT group (P<0.05). Furthermore, compared with the CHPF group, the incision length was significantly shorter with reduced hemorrhage in the MCDT group (P<0.05). In conclusion, the results of the current study suggest that MCDT is more simple, convenient and efficient compared with CCDT, and is worth popularizing.

Suture Button Versus Hook Plate for Acute Unstable Acromioclavicular Joint Dislocation: A Meta-analysis

“…Functional outcomes were assessed with the Constant score, as reported in 8 studies comprising 195 SB procedures and 187 HP procedures. 3,4,15,23,24,36,45,46 The SB procedure resulted in a mean Constant score of 91.59, as compared with 87.16 for the HP procedure. There was a statistically significant difference in favor of the SB technique (MD, 3.95; 95% CI, 1.20-6.70; I 2 = 77%; P = .005) ( Figure 2).…”

“…Finally, 8 clinical trials with 399 patients were included in the present meta-analysis. 3,4,15,23,24,36,45,46 A flowchart of the literature search is shown in Figure 1.…”

“…11,32,35 Recently, several comparative studies have aimed to evaluate the treatment outcomes for acute unstable AC joint dislocation with the SB versus HP technique. 3,4,15,23,24,36,45,46 The clinical results of both surgical techniques have been satisfactory, although there has been no clear consensus on which method produces superior outcomes.…”

Arthroscopic Suture-Button Versus Hook-Plate Fixation for Acromioclavicular Joint Injuries—A Systematic Review of Comparative Studies

“…The CM score was reported in 5 studies, with 3 studies finding a significant difference in favor of SB, including the 1 RCT comparing functional outcomes. 4 , 13 , 15 , 20 , 21 The mean CM score ranged between 87.6 and 95.3 for SB and between 77.5 and 91.3 for HP.…”

“…There were 6 studies (LOE I: 2, LOE II: 1, LOE III: 3) including 135 patients treated with SB and 150 patients treated with HP ( Tables 1 and 2 ). 4 , 11 , 13 , 15 , 20 , 21 The median Newcastle Ottawa scale score was 7 (range 6-8). One additional study was removed as it was based on the same randomized controlled trial (RCT) and did had an overlap of patients.…”