Comparison between Trans-articular and Subacromial Stabilization with Ligament Repair for Acute Acromioclavicular Dislocation



Noboru Matsumura1, *, Yusuke Kawano1, Ryogo Furuhata1, Hiroo Kimura1, Taku Suzuki1, Takuji Iwamoto1
1 Department of Orthopedic Surgery, Keio University School of Medicine, Japan

Abstract

Background:

Although numerous treatment options for acromioclavicular joint dislocation have been reported, the treatment strategy is not yet standardized.

Objective:

The purpose of this study was to evaluate the clinical and radiographic results of coracoclavicular ligament repair with temporary acromioclavicular stabilization using suture anchors and Kirschner wires, and to compare the results between temporary trans-articular fixation and subacromial stabilization of the acromioclavicular joint.

Methods:

Thirty-three cases with displaced acromioclavicular joint dislocation were retrospectively evaluated. In the first 14 cases, the wires temporarily penetrated the joint for an average of 7 weeks (trans-articular group), while the acromioclavicular joint was temporarily stabilized by wires passing under the acromion that were inserted into the distal clavicle for an average of 13 weeks in the latter 19 cases (subacromial group). Clinical and radiographic results were evaluated and compared between the two groups.

Results:

The average UCLA score was 32.0 points in the trans-articular group and 32.8 points in the subacromial group, indicating no difference between the two groups (P = 0.418). Coracoclavicular distance ratio after surgery was significantly smaller in the subacromial group (P ≤ 0.035), and acromioclavicular dislocation ratio after removal of the wires was also smaller in the subacromial group (P ≤ 0.001) compared with the trans-articular group.

Conclusion:

This study revealed that coracoclavicular ligament repair with temporary acromioclavicular stabilization leads to favorable clinical results, with the subacromial group showing better maintenance of joint reduction compared with the trans-articular group. Subacromial wire stabilization is a viable option for long-term temporary fixation of acute displaced acromioclavicular joint dislocation.

Keywords: Acromioclavicular joint dislocation, acromioclavicular separation, coracoclavicular ligament repair, temporary fixation, temporary stabilization, suture anchors.


Abstract Information


Identifiers and Pagination:

Year: 2019
Volume: 13
First Page: 03
Last Page: 09
Publisher Item Identifier: EA-TOORTHJ-2019-30

Article History:

Received Date: 24/06/2019
Revision Received Date: 13/09/2019
Acceptance Date: 18/10/2019
Electronic publication date: 21/11/2019
Collection year: 2019

© 2019 Matsumura et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


* Address correspondence to this author at the Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan; Fax: +81-3-3353-6597; Tel: +81-3-5363-3812; Email: noboru18@gmail.com