A comparative study of short-term outcomes of Tossy grade III acromioclavicular separation between double Endobutton technique and clavicular hook plate

Abstract

Objective To compare short-term outcomes of double Endobutton technique versus clavicular hook plate (CHP) in the treatment of Tossy grade Ⅲ acromioclavicular separation.Methods A cohort of 59 patients with Tossy grade Ⅲ acromioclavicular dislocation were treated between March 2009 and December 2011 in our department.They were 41 men and 18 women,aged from 21 to 69 years (average,44.0 years).Twenty-one left shoulders and 38 right ones were affected.Twenty-six patients were treated with double Endobutton technique (group A) and 33 with CHP (group B).The 2 groups were similar in general clinical data (P ＞ 0.05).They were compared in terms of postoperative visual analogue scale (VAS) scores,abduction-rise,flexion-rise,Constant-Murley scores and Karlsson grading for functional recovery of the injured shoulder.Results The mean follow-up time was 15.2 months (from 11 to 30 months).At 9 months post-surgery,the average VAS score was 2.1 ± 0.7 points for group A and 2.9 ± 0.8 points for group B,the abduction-rise and flexion-rise averaged 100.8°± 13.2° and 131.5°± 13.3° for group A and 81.3°±8.3°and 96.6° ± 10.8° for group B.There were significant differences between the 2 groups in the above indexes (P ＜ 0.05),but not in the average Constant-Murley scores (85.3 ± 6.3 versus 82.4±6.1 points) or Karlsson grading of excellent to good cases (84.6％ venus 90.9 ％) (P ＞ 0.05).Conclusions In management of grade Ⅲ acromioclavicular separation,compared with CHP,double Endobutton technique can result in similar functional outcomes but a greater range of motion and less shoulder pain at the early post-surgery stage. Key words: Acromioclavicular joint; Shoulder dislocation; Ligament, articular; Internal fixator