Comparison of hook plate fixation and ligament reconstruction in treatment of acute unstable acromioclavicular joint dislocation

doi:10.3877/cma.j.issn.2095-9133.2016.01.007

Abstract

Abstract:

Objective

To compare clinical and radiographic outcomes of hook plate fixation and coracoclavicular ligament reconstruction in the treatment of acute unstable acromioclavicular joint dislocation.

Methods

Fiftypatients with acute unstable dislocation of the acromioclavicular joint were enrolled in the study and divided into two groups according to the treatment modality, ie, internal fixation with a hook plate group (Group I, 20 cases) and coracoclavicular ligament reconstruction group (Group II, 30 cases). The clinical outcomes were evaluated using Constant- Murley score (CMS) and visual analog scale (VAS) and the radiographic outcomes assessed based on coracoclaviculardistance (CCD).

Results

The mean CMS score was(94.4±6.97) points and (95.87±3.50) points in Groups I and II, respectively, with no statistical difference. The mean VAS scores at the final follow-up was (0.85±0.93) points and (0.87±0.82) points in Groups I and II, respectively, with no statistical difference. The acromioclavicular joints were well reduced in both groups. CCDwas improved from preoperative (15.91±5.29)mm to postoperative (6.94±2.90)mm in Group I, with an improvement of (263.00±181.45)%, and from preoperative (15.10±6.43)mm to postoperative (5.54±2.10)mm in Group II, with an improvement of (293.67±116.39)%. The improvement in Group I was not significantly superior to that in Group II(P>0.05) Subluxation was observed in both groups, with higher incidence in Group II(26.7%) than that in Group I(15%). However, erosions of the acromion undersurface and osteoarthritis of acromioclavicular were only observed in group I, with an incurrence of 80% and 25%, respectively. Furthermore, coracoclavicular ligament ossification shown more frequently in group I (35%) than group II (13.3%).

Conclusions

For acute unstable acromioclavicular joint dislocation, hook plate fixation and coracoclavicular ligament reconstruction can attain comparable satisfactory clinical and radiographicoutcomes. Hook plate should be moved earlier to avoid the complication. Subluxation is the major complication of ligament reconstruction.

Key words: Dislocation, Acromioclavicular joint, Hook plate fixation, Endobutton, Ligament reconstruction

Zhiyuan Liu, Jianguo Zhu, Lei Yang. Comparison of hook plate fixation and ligament reconstruction in treatment of acute unstable acromioclavicular joint dislocation[J]. Chinese Journal of Hygiene Rescue(Electronic Edition), 2016, 02(01): 21-25.

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References 20

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组别	例数	性别(男/女)	年龄	侧别(左/右)	受伤至手术时间(天)	Rockwood分型(Ⅲ/Ⅴ)
Ⅰ组	20	11/9	48.3±11.4	10/10	3.6 ±4.2	14/6
Ⅱ组	30	21/9	48.1±11.1	23/7	5.1±3.4	21/9
t值	?	0.91	0.04	－1.79	－1.37	0.07
P值	?	>0.05	>0.05	>0.05	>0.05	>0.05

组别	例数	性别(男/女)	年龄	侧别(左/右)	受伤至手术时间(天)	Rockwood分型(Ⅲ/Ⅴ)
Ⅰ组	20	11/9	48.3±11.4	10/10	3.6 ±4.2	14/6
Ⅱ组	30	21/9	48.1±11.1	23/7	5.1±3.4	21/9
t值	?	0.91	0.04	－1.79	－1.37	0.07
P值	?	>0.05	>0.05	>0.05	>0.05	>0.05

组别	VAS评分	CMS评分
A组	0.9±0.9	94.4±7.0
B组	0.9±0.8	95.9±3.5
t值	－0.07	－0.86
P值	>0.05	>0.05

组别	VAS评分	CMS评分
A组	0.9±0.9	94.4±7.0
B组	0.9±0.8	95.9±3.5
t值	－0.07	－0.86
P值	>0.05	>0.05

组别	CCD术前	CCD术后	CCD改善率(%)
A组	15.9±5.3	15.1±6.4	263.0±181.5
B组	6.9±2.9	5.5±2.1	293.7±116.4
t值	?	?	0.72
P值	?	?	>0.05

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