Comparison of Long-term Results of the Operative Stabilization of Acromioclavicular Joint Dislocation Using Either Tension Band Technique with Two Unthreaded Kirschner Wires and a Cerclage Wire or an Acromioclavicular Hook Plate

Abstract

Background: Dislocation of the acromioclavicular joint is a common injury, especially among young and/or active people. Mild lesions are usually treated conservatively, whereas surgical treatment is indicated for high-grade dislocations. Surgical methods can be grossly divided into extra- and transarticular fixation techniques, depending on whether or not the implant directly crosses the joint. Tension band technique with two unthreaded Kirschner wires and a cerclage wire represents the classic transarticular technique, whereas stabilization with a hook plate is one of the most frequently used extraarticular techniques. We hypothesized that transarticular fixation would promote the onset of AC joint osteoarthritis and therefore lead to a worse clinical outcome. The purpose of this study was to compare the long-term results of the two mentioned surgical procedures and to demonstrate the advantage of one method. Methods: We followed up on 64 patients who were operated on for AC joint dislocation with one of the two mentioned surgical techniques between 1999 and 2005 at the Hospital for Trauma Surgery, Graz. The radiographic examination consisted of anteroposterior AC and axillary radiographs for each shoulder as well as bilateral AP stress radiographs. The clinical follow-up consisted of a detailed anamnesis in addition to the evaluation of the Constant score, UCLA score, and the DASH outcome measure. Results: We could not detect a statistically significant difference concerning the occurrence of posttraumatic AC joint osteoarthritis between the two groups (P=.26). There were no significant differences concerning the score results (Constant score: P=.06; UCLA score: P=.05; DASH score: P=.45), the occurrence of shoulder pain (P=.60), and the satisfaction of the patients (P=.36) between the two groups. The total length of hospitalization (P=.01) as well as the occurrence of loosening or breakage of the implants (P

Date of Award	2011
Original language	English
Awarding Institution	Medical University Graz
Supervisor	Wolfgang Grechenig (Co-supervisor) & Michael Plecko (Co-supervisor)