EVALUATION OF ARTHROSCOPIC BUTTON AND FIBER TAPE FIXATION IN ACROMIO-CLAVICULAR JOINT INJURIES

Abstract

BACKGROUND: Acromio-clavicular injuries (ACI) account for 9% of all shoulder injuries. The injuries are divided into VI types according to Rockwood classification. Surgery is indicated in Type IV to VI and often in Type III injuries. The optimal surgery for these injuries is debatable, though arthroscopic fixation is increasingly being preferred due to small incisions, early rehabilitation and reduced hardware. Dog-bone button (arthroscopic button) is a broad anatomically contoured button and when used with Fiber-tape offers an excellent option to reconstruct the Acromio-Clavicular joint (ACJ). Our study is to evaluate the results of this fixation by using the Constant Score. Thirty (30) adultMETHODS: patients with Type III-V ACI were operated arthroscopically with Dog-Bone Button and Fiber-tape fixation. The patients were followed up for a period of 6 months. Constant score, range of motion of shoulder joint and Coraco-clavicular distance were taken pre-operatively and 6 months after the surgery. Twenty-two patients had RW III injury, sixRESULTS: patients had RW IV and two patients had RW V injury. The mean pre-operative Constant Score was 58.53 (±7.38) and the mean post-operative Constant Score at 6 months was 89.83 (± 9.16). The difference between constant score was statistically significant (p<0.001). Mean preoperative CC distance was 20.27+ 2.3mm to 10.28 mm + 3.12mm at 6 months follow up. Similarly, the difference between pre-operative and post-operative range of motion in flexion and abduction was significant on paired data analysis (p<0.001). One patient had subluxation of AC joint after surgery and had to be re- operated with a threaded K-wire. Arthroscopic Dog-bone button fixation provides good functionalCONCLUSIONS: and radiological outcome and is a viable method to reconstruct acute acromio-clavicular joint injuries.