Long-term outcomes of tension band wiring with a single K-wire in Rockwood type IV/V acute acromio-clavicular dislocations: 25 cases

Abstract

BackgroundOur objective was to evaluate the long-term functional and radiological outcomes of tension band wiring with a single K-wire for acute Rockwood types IV and V acromio-clavicular dislocation (ACD). MethodsSingle-centre cross-sectional non-randomised observational cohort study of 25 shoulders treated surgically between January 2002 and December 2004, in 25 patients, 23 males and 2 females, with a mean age of 35±11years (24–46). The evaluation criteria were the absolute and weighted Constant scores, QuickDASH score, subjective shoulder value (SSV), visual analogue scale (VAS) pain score at rest and during activities, and radiographic features in clinically symptomatic patients. ResultsMean values were as follows: follow-up, 150±17months (133–167); absolute Constant score, 88±17 (71–105); weighted Constant score, 92.5±12.5 (80–105); QuickDASH, 15.5±7 (8.5–22.5); SSV, 88±17% (71–105); VAS pain score at rest, 0.2±0.7 (0–0.9); and VAS pain score while active, 1.4±2.3 (0–3.7). The weighted Constant score was less than 70% in only 8% of patients. Of the 17 patients for whom radiographs were obtained, 8 had acromio-clavicular osteoarthritis. Mean coraco-clavicular distance was 12.3±4.3mm (8–16.6) and mean acromio-clavicular distance was 5±5mm (0–10). The recurrence rate was 8%. ConclusionTension band wiring with a single K-wire for acute acromio-clavicular dislocation reliably provides good long-term functional outcomes. Recurrences are uncommon and few patients experience symptoms (8%). Level of evidenceIV, retrospective study.