Acute acromioclavicular dislocations: results of coracoclavicular screw fixation

Abstract

BackgroundThe vast majority of traumatic dislocations of the acromioclavicular joint (ACJ) occur either during sports or other daily activities. Most frequently, the mechanism of injury is force acting on the shoulder from the lateral side with the arm in an adducted position.Patients and methodsTwenty patients with recent complete acromioclavicular dislocation were treated operatively by coracoclavicular screw fixation, repair of torn ligaments, together with exploration and debridement of the ACJ. Sling immobilization for 2 weeks and early postoperative rehabilitation were carried out.ResultsPatients were followed up for a period ranging from 6 to 30 months (average 18 months). According to Constant score, 14 patients had an excellent score, four had a good score, and two had a fair score, and there were no poor results.ComplicationsImplant failure with backing out of the screw occurred in one patient 6 weeks postoperatively, with no influence on the final outcomes, and a superficial wound infection occurred in three patients and required no further surgical treatment; only dressing and oral antibiotics were required for 2 weeks. Shoulder stiffness was mild in two patients and did not affect the patient's daily activities.ConclusionGood results can be obtained in complete types III, IV, and V (ACJ) on separation by repair of both acromioclavicular and coracoclavicular ligaments, proper fixation of the screw, repair of deltotrapezius muscles and fascia, and meticulous adherence to the postoperative rehabilitation program.