Results of Treatment of Type 3 Acromioclavicular Joint Dislocation with Three Methods

Abstract

Background. Rockwood Type III acromioclavicular joint injuries are treated both conservatively and surgically. There is still no consensus on an optimal fixation method. The aim of this study was to evaluate which of the surgical methods used in our Department produces the best outcomes in long-term follow-up. Material and methods. The study involved 27 patients. Wire cerclage was used in 12 patients, 11 patients were operated on by the Ladermann method, and a hook plate was used in 4 patients. The patients were assessed at a late follow-up visit after a mean of 22 months post-operatively. The Constant Shoulder Scale (CSS), Oxford Shoulder Scale (OSS), and PROMIS v1.2 for the upper limb were used to assess the long-term effects of the treatment. Results. There were no statistically significant differences between the Ladermann method and wire cerclage for the scales applied (p=0.98 at α=0.05). The functional CSS showed a significant advantage of the outcomes of the Lader­mann method and wire cerclage in comparison to the hook plate (p=0.014 and p=0.004, respectively, at α=0.05). The quality of life scales OSS and PROMIS showed no significant difference between the methods. Conclusions. 1. The outcomes of treatment with the Ladermann method and wire cerclage are excellent and com­parable with regard to both clinical outcomes and the quality of life. 2. The use of a hook plate may substantially contribute to worse clinical outcomes. 3. No considerable difference was found in the quality of life between the different groups, but a study involving a larger number of patients would be necessary for a complete evaluation.

Comparison of Effectiveness and Safety in Treating Acute Acromioclavicular Joint Dislocation with Five Different Surgical Procedures: A Systematic Review and Network Meta‐Analysis

“…With careful full‐text reading, 56 studies were excluded for the reasons shown in Figure 1. Finally, 31 articles were included in our study 24–54 …”

“…Finally, 31 articles were included in our study. 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 …”

Surgical Management of Acute Rockwood Grade III Acromioclavicular Joint Dislocations: A Systematic Review

“…After screening titles/abstracts for satisfying inclusion/exclusion criteria, 177 abstracts were further excluded, leaving 34 unique studies for full-text review. Finally, 14 studies that reported outcomes after the surgical management of acute Rockwood grade III acromioclavicular dislocations were included in this systematic review (Figure 1) [12,19,[26][27][28][29][30][31][32][33][34][35][36][37].…”

“…Łazarski et al reported statistically significant improved CM scores in patients randomized to techniques in group 2 compared to the use of hook plates in group 1 (p = 0.04) [ 28 ]. Ye et al and Zhang et al also compared the use of hook plates (group 1) to a semitendinosus graft plus Endobuttons and the modified/common closed-loop double-button technique (group 2), respectively, both reporting generally better functional outcomes in patients who had the group 2 procedures [ 34 , 37 ].…”

Travmatik Tip III Akromiyoklaviküler Eklem Çıkığı Tedavisinde Kanca Plak ile Tespit İdeal Bir Tedavi Yöntemi Midir?

“…Fakat aynı çalışmada bu üç yöntemin yaşam kalitesi açısından benzer olduğu belirtilmiştir. [12] Yapılan bir çalışmada; akromiyoklaviküler eklem çıkıkları için endo buton uygulanan hastaların, kanca plak uygulanan hastalara göre, erken dönem sonuçlarının daha iyi olduğu ancak bir yıllık takip sonunda, sonuçlarının benzer olduğu bildirilmiştir. [13] Rockwood tip III akromiyoklaviküler eklem çıkıklarında, korakoklaviküler ligaman tamiri yapmadan kanca plak uygulanması iyi bir uygulama olarak bildirilmiştir.…”