First experience of the surgical treatment of acute dislocation of clavicle acromial end

Abstract

Over 100 methods of the surgical treatment of the dislocation of clavicle acromial end is known nowadays. Anatomic-biomechanic peculiarities of acromioclavicular joint and its ligamentous appa­ratus stipulate such a variety, at first, and secondly, this fact shows some disadvantages of every method. Moreover, it was defined, that complete restoration of function does not happen in 16.5–35.2 % cases. This fact shows the relevance of working out and implementa­tion of new treatment techniques. The goal: to improve the results of treatment of acromioclavicular joint injury using the restoration of coracoclavicular ligament with arthroscopic control. Methods: 5 patients (at the age from 18 to 42 years) with acute injury of ac­romioclavicular joint underwent an operation using arthroscopic equipment. The fixation of joint was carried out with «AKK rigging / АКК Такелаж» system in high-endurance nonabsorbable material. Immobilization duration in triangular bandage was equal to 2–3 weeks depending upon the severity of pain syndrome. Follow-up controls (clinical and radiographic assessment) were performed 1 and 3 months after surgery. Results: using of the method proposed for restoration of acute injures of acromioclavicular joint allowed to obtain good and excellent results in all patients after surgery. The range of motion in shoulder joint was restored in all patients completely. The proposed technique means surgery through little incisions (0.5 cm) that provide good cosmetic results. A positive feature of proposed technique is a minimal operation trauma, as far as you have not to expose a clavicle and subclavicular space for drilling it and fixator implementation. Conclusion: using of arthroscopic equipment for the restoration of acromioclavicular joint facilitates decreasing of operation trauma, terms of immobi­lization, allows predicting positive long-term results and restoring complete motion in shoulder joint.