Importance of additional temporary pin fixation combined coracoclavicular augmentation using a suture button device for acute acromioclavicular joint dislocation.

Abstract

We evaluated the outcomes of coracoclavicular (CC) augmentation using a suture button device with additional temporary pin fixation for acute acromioclavicular (AC) joint dislocation. Thirty-six consecutive cases who underwent CC augmentation using TightRope™ (Arthrex, Naples, FL, USA) were included. We temporarily fixed trans-articular pins in the first 10 cases (TA group) and a trans-spine pin in the next 26 cases (TS group). The radiological and clinical outcomes were evaluated at minimum 2years postoperatively. The mean follow-up period was 56.7months (range, 24-84months). At the final follow-up evaluation, reduction status showed anatomical reduction in 25 cases (69.4%), slight loss of reduction in seven cases (19.4%), partial loss of reduction in two cases (5.6%), and total loss of reduction in two cases (5.6%). The mean ASES score, UCLA score, and subjective shoulder value were 92.3, 32.9, and 91.6%, respectively. There were no significant differences between the two groups with respect to the outcomes. Intraoperative complications occurred in three cases (8.3%) including two cases of failed reduction and one case of technical failure of the implant. Postoperative complications occurred in three cases (8.3%) including one case of pin tract infection and distal clavicle fracture at the clavicle-hole, one case of reduction loss by severe subsidence of the clavicular button, and one case of shoulder stiffness. CC augmentation using a suture button device with temporary pin fixation yielded satisfactory radiological and clinical outcomes. These results support that temporary pin fixation for the AC joint may help to protect the AC reduction in the early phase of healing and rigid scar formation when performing CC fixation using a suture button device. Level-IV, Retrospective Case Series, Treatment Study.