Acromioclavicular joint dislocation treated with Bosworth screw and additional K-wiring: results after 7.8\xa0years \u2013 still an adequate procedure?

Thomas M Tiefenboeck,Roman C Ostermann,Julian Joestl,Harald Binder,Domenik Popp,Stephan Payr,Sandra Boesmueller,Mark Schurz,Micha Komjati

doi:10.1186/s12891-017-1692-0

Thomas M Tiefenboeck, Roman C Ostermann + Show 7 more

Open Access

https://doi.org/10.1186/s12891-017-1692-0

Copy DOI

Abstract

BackgroundThe acromioclavicular (AC) joint dislocation is a major reason for shoulder instability. Different concepts of treatment and surgical methods are described in the literature. Thus, the purpose of this study was to present our data of long-term follow-up of patients having undergone treatment of acromioclavicular (AC) joint dislocation using the Bosworth Screw with additional K-wiring.MethodsThis study was conducted as a retrospective single centre data analysis. All patients treated operatively for AC joint dislocation with a Bosworth screw and additional K-wire fixation at our Department were asked to participate in this study.ResultsThe study population consisted of 22 patients, 20 male and 2 female, with a mean age of 40 years ±15.6 years. Three grade-II lesions, 13 grade-III lesions, four grade-IV lesions and two grade-V lesions according to the Rockwood classification were found. The overall mean clinical outcome at the latest follow up was: Constant 95, DASH 6.4, ASES 94.6, SST 99.02, UCLA 33.1, ACJI 91.82 and VAS 0.29 – representing a good-to-excellent long-term outcome in all patients after at least 2 years follow-up (range; 2 - 19 years). Overall, 19 patients (86%) reported to be very satisfied with the achieved result, 15 patients (68%) reported to be able to participate in every sports activity and 16 patients (73%) reported to be able to perform their daily work without limitations. Overall, complications occurred in three patients (14%). Only one patient remained unsatisfied with the achieved result.ConclusionSummarizing, our reported results showed that surgical fixation of acute AC joint dislocation with a Bosworth screw and additional K-wire fixation leads to good-to-excellent functional outcome and highly satisfactory results in the majority of patients. Despite its complications, in accordance with our results, Bosworth screw fixation with additional K-wiring in AC joint dislocation represents an adequate surgical procedure.Level of Evidence: Level IV, retrospective study.

Highlights

The acromioclavicular (AC) joint dislocation is a major reason for shoulder instability
All database files and medical records of patients treated with Bosworth screw fixation and additional K-wiring for an acute AC joint dislocation were retrospectively reviewed for clinical and radiological outcome
Three different surgical methods were used at our Department to treat AC dislocations – Bosworth screw and K-wiring, reconstruction with the LARSTM system and the TightRope® system

Summary

Introduction

The acromioclavicular (AC) joint dislocation is a major reason for shoulder instability, typically associated with a direct high-energy trauma to the shoulder or strong force on the outstretched arm [1,2,3] It often occurs in young and athletic patients emphasizing the importance of restoring normal anatomy and function for full recovery [4]. The theory was that the graft enabled natural healing of the torn CC ligaments [10, 11] To this day, only limited data is available regarding this technique [10] even when used in acute AC dislocations [12]

Objectives

Methods

Results

Discussion

Conclusion