Double-attack technique in surgical treatment of acute complete acromioclavicular joint dislocation

Abstract

Introduction Acromioclavicular joint (ACJ) dislocation often affects young athletes, and those involved in road traffic accidents and fall from height. Majority of these patients sustain high-grade injuries requiring surgical management to allow them to return to their sports. Patients and methods This was a prospective study of 16 patients with acute complete ACJ dislocations treated in Zagazig University Hospital in the period between February 2008 and January 2012. All patients were treated surgically using coracoclavicular screw fixation passed from the clavicle to the base of the coracoid process of the scapula supplemented with transfer of a half-thickness coracoacromial ligament with attached bone fragment to the distal clavicle. Results According to the Rockwood classification, five (31%) patients had type III lesion, four (25%) had type IV lesion, and seven (44%) had type V lesion. Ten (62.5%) patients showed excellent results, two (12.5%) showed good results, one (6.25%) showed a fair result, and one (6.25%) showed a poor result. Conclusion Open reduction and internal fixation of acute complete ACJ injury using the double-attack technique, coracoclavicular screw fixation supplemented with medial half coracoacromial ligament reconstruction, is technically simple, with high rates of satisfactory results, as it allows good functional outcome of the shoulder joint.