A Comparison of the Modified Bosworth and Endobutton Techniques in the Surgical Treatment of Rockwood Type III Acromioclavicular Joint Dislocations

Abstract

Aim: In this study, we aimed to retrospectively compare the long-term clinical and radiological outcomes obtained with the modified Bosworth technique and Endobutton technique in surgical treatment of type III acromioclavicular dislocations.Materials and Methods: Thirty-two patients (26 males, 6 females) (mean age 37, range 15–78 years) were treated surgically for acromioclavicular joint (ACJ) dislocation. All patients had type III dislocation. Twenty-two patients had right ACJ dislocation and 10 patients had left ACJ dislocation. Of the dislocations, 18 occurred due to falls; 9, sports injuries; and 5, traffic accidents. Of the patients, 18 were operated on with the Endobutton technique and 14 with the modified Endobutton technique. Patients were evaluated postoperatively in terms of functional Constant, DASH, and VAS scores and radiologically with coracoclavicular distance (CCD) assessment. The mean follow-up was 52 (37–66) months.Results: The alignment of the acromioclavicular joint was normal in all patients. No joint degeneration was observed in any patient. Shoulder movements were painless and complete in all patients. The mean postoperative 3rd, 12th, and 24th month Constant scores were found significantly higher for the Endobutton group than for the modified Bosworth group (p=0.001). The mean postoperative 3rd, 12th, and 24th month DASH scores were significantly lower for the Endobutton Group than for the modified Bosworth group (p=0.003). The mean postoperative 3rd, 12th, and 24th month VAS scores were significantly lower for the Endobutton group than for the modified Bosworth group (p=0.001). However, no statistically significant difference was found between the mean preoperative and postoperative CCD values of the two groups (p=0.104). Discussion and Conclusion: The Endobutton technique is a good alternative to the modified Bosworth technique in the surgical treatment of acromioclavicular dislocations.