Acute high-grade acromioclavicular joint dislocation patients treated with titanium cable insertion under a homemade guider

Jun Wang,Yuhang Zhang,Yongfeng Cui,Hang Yin

doi:10.1186/s13018-021-02442-1

Abstract

BackgroundsTo describe a new technique for implanting a double-bundle titanium cable to treat acromioclavicular (AC) joint dislocation via the new guider, and evaluate clinic outcomes.MethodsA retrospective study of patients treated for acute high-grade acromioclavicular joint dislocation from June 2016 to January 2020 in our trauma center, twenty patients with AC joint dislocation were managed with double-bundle titanium cable. It includes the following steps: (1) Put the guider under the coracoid close to the cortical; (2) drill proximal clavicle; (3) place the titanium cable; (4) perforate distal clavicle, (5) reset the acromioclavicular joint and lock titanium cable; and (6) suture the acromioclavicular ligament. An independent reviewer conducted functional testing of these patients, including the use of coracoclavicular distance (CCD), visual analog scale (VAS) scores, and Constant–Murley scores (CMS).ResultsAll patients are presented following at a median duration of 15 months (12-24months) after the surgery. All patients based on X-ray evaluation and clinic evaluation. The median CCD was 7.5 (6–14) mm, the VAS score was 0.55 (0-2), the CMS score was 95.5 (92-99). One patient had subluxation again at the final follow-up based on X-ray examination.ConclusionsThis study demonstrates that the AC joint fixation anatomically with double-bundle titanium, acquired excellent outcomes in terms of the recovery of shoulder joint function and radiographic outcomes. It has a low complication rate and need not remove the hardware.

Highlights

Acromioclavicular (AC) joint dislocation is a common disease in upper limb trauma, accounting for 2 to 16% of total joint dislocations and 12% of shoulder injuries [1]
AC joint dislocations can be classified according to the Rockwood classification based on the degree and direction of dislocation
Different surgical fixation methods were available for the treatment of AC dislocations

Summary

Introduction

Acromioclavicular (AC) joint dislocation is a common disease in upper limb trauma, accounting for 2 to 16% of total joint dislocations and 12% of shoulder injuries [1]. When AC joint dislocation occurs, it produces shoulder pain, and movement of the entire upper extremity. AC joint dislocations can be classified according to the Rockwood classification based on the degree and direction of dislocation. Types I or II of AC dislocation are Different surgical fixation methods were available for the treatment of AC dislocations. No consensus regarding the method has been reached.

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