Background: several surgical techniques and implants have been proposed
for treatment of acute acromioclavicular joint (ACJ) dislocation. The
purpose of the study was to assess the results of hook plate fixation
combined with coracoclavicular ligaments repair and augmentation for
management of acute acromioclavicular joint dislocation.
Patients and Methods: Between March 2011 and October 2014, 22 patients
(15 male and 7 female) with acute acromioclavicular joint (ACJ) dislocation
were treated with open reduction and hook plate fixation with
coracoclavicular (CC) ligaments repair and augmentation at Benha
University Hospital. The inclusion criteria included patients with isolated
acute acromioclavicular joint dislocation grade III-V according to Rockwood
classification. Exclusion criteria were neglected cases >4 weeks, chronic
dislocations, open dislocation and fracture dislocation of the ACJ. The
average age of the patients was 31.8 years (+_9.7 years) ranging from 18
years to 60 years. The right side was affected in 14 patients and the left in 8
patients. Functional outcomes were assessed according to ROM and the
Constant- Murley scoring system, DASH Score, and Visual Analogue Scale
(VAS) Score for pain.
Results: The mean operative time was 66 minutes (50-90min). The mean
follow-up period was 20.3 (±7.8) months ranging from 12 to 40 months. In
all but one of the 22 cases, the plates were removed after 3-6 months. The
mean postoperative shoulder forward flexion was 160.4° (±15.8°), the
extension was 51° (±8.6°), internal rotation 58.1° (±11.7°), external rotation
was 68.1° (±12.7°) and abduction was 160.4° (±18.3°). The mean Constant
Score was 94(±5.1). The mean DASH Score was 8.7 (±4.8). The mean pain
VAS Score was 1.2 (±1). No major complications occurred in the current
study except one case developed an asymptomatic 1cm widening of the AC
distance after 12 months. No patient developed wound infection,
redislocation, AC ligament ossification or acromion osteolysis over the hook
even in the only case of retained plate for 18 months.
Conclusion: The use of hook plate is a good choice for stabilization of acute
AC joint dislocation. When combined with coracoclavicular ligaments repair
and augmentation, the complication rates was law with good functional
outcome. |
