Posts

Acute Complete Acromioclavicular Dislocations: A Prospective Multicenter Therapeutic Study Comparing Combined Intra-articular and Extra-articular Fixation with Intra-articular K-wire Fixation

Vol 3 | Issue 2 | Sep – Dec 2017 | page: 21-24 | Biswajit Sahu, Ranajit Panigrahi, Nishit Palo, Ashok Priyadarshi, Saswat Samant


Author: Biswajit Sahu [1], Ranajit Panigrahi [2], Nishit Palo [3], Ashok Priyadarshi [4], Saswat Samant [5].

[1] Department of Orthopaedics, VSS Medical College.
[2] Department of orthopedics, Hi-Tech Medical College
[3] Department of Orthopaedics, Santosh Medical College,Ghaziabad, UP.
[4] Department of orthopedics, Hi-Tech Medical College, Bhubaneswar

Address of Correspondence
Dr Saswat Samant
Department of Orthopaedics, Hi-tech Medical College
Bhubaneswar.
Email: Saswatsamant135@gmail.com


Learning Points for this Article: Isolated intra-articular K-wire fixation also fails to provide the required stability to the injured joint, especially in developing countries, where patients fail to adhere to the rehabilitation protocol. Thus, combining both, the intra-articular and coracoclavicular fixations seem to be a promising modality in terms of stability and secure fixation. Combining the intra- and extra-articular techniques significantly decreases the complication rates as seen with the isolated fixation techniques.


Abstract

The AC joint is commonly involved in traumatic injuries that affect the shoulder.Treatment of these injuries has been controversial and continues to evolve to this day ranging from conservative management and k-wire fixations to screw fixation, and more recently, arthroscopically assisted ligament reconstructions with no definite consensus about the ideal method of treatment.Each modality has its own advantages and disadvantages. In this prospective therapeutic multicenter study, we compared combined intra-articular fixation and screw coracoclavicular repair versus the intra-articular fixation with k-wires alone to assess the stability, failure rates, and outcomes of combining the two methods of fixation versus isolated intra-articular fixation.combining both, the intra-articular and coracoclavicular fixations seem to be a promising modality in terms of stability and secure fixation. Combining the intra- and extra-articular techniques significantly decreases the complication rates as seen with the isolated fixation techniques.
Keywords: Acromioclavicular dislocations, intra-articular, multicenter.


References

1. Simovitch R, Sanders B, Ozbaydar M, Lavery K, Warner JJ. Acromioclavicular joint injuries: Diagnosis and management. J Am Acad Orthop Surg 2009;17(4):207-219.
2. Galatz LM, Hollis Jr RF, Williams Jr GR. Acromioclavicular Joint Injuries. Rockwood and Green’s Fractures in Adults. 7th ed. Philadelphia: Lippincott Williams & Wilkins; 2010. p. 1210-1242.
3. De Carli A, Lanzetti RM, Ciompi A, Lupariello D, Rota P, Ferretti A. Acromioclavicular third degree dislocation: Surgical treatment in acute cases. J Orthop Surg Res 2015;10(1):13.
4. Saccomanno MF, Fodale M, Capasso L, Cazzato G, Milano G. Reconstruction of the coracoclavicular and acromioclavicular ligaments with semitendinosus tendon graft: A pilot study. Joints 2014;2(1):6-14.
5. Steinbacher G, Sallent A, Seijas R, Boffa JM, Espinosa W, Cugat R. Clavicular hook platefor grade-III acromioclavicular dislocation. J Orthop Surg (Hong Kong) 2014;22(3):329-332.
6. Zhu YY, Cui HY, Jiang PQ, Wang JL. Complications of treatment of acromioclavicular joint dislocation and unstable distal clavicular fracture with clavicular hook plate. Zhongguo Gu Shang 2013;26(11):927-931.
7. Virtanen KJ, Savolainen V, Tulikoura I, Remes V, Haapamäki V, Pajarinen J, et al. Surgical treatment of chronic acromioclavicular joint dislocation with autogenous tendongrafts. Springerplus 2014;3:420.
8. Stucken C, Cohen SB. Management of acromioclavicular joint injuries. Orthop Clin North Am 2015;46(1):57-66.
9. Tidwell JE, Kennedy PM, McDonough EB. Concurrent treatment of a middle-third clavicle fracture and Type IV acromioclavicular dislocation. Am J Orthop (Belle Mead NJ) 2014;43(11):E275-E278.
10. Pan Z, Zhang H, Sun C, Qu L, Cui Y. Arthroscopy-assisted reconstruction of coracoclavicular ligament by Endobutton fixation for treatment of acromioclavicular joint dislocation. Arch Orthop Trauma Surg 2015;135(1):9-16.
11. Williams GR, Nguyen VD, Rockwood CR. Classification and radiographic analysis of acromioclavicular dislocations. Appl Radiol 1989;12:29-34.
12. Tossy JD, Mead NC, Sigmond HM. Acromioclavicular separations: Useful and practical classification for treatment. Clin Orthop Relat Res 1963;28:111-119.
13. Adams FL. The Genuine Works of Hippocrates. Vol. 1-2. New York: William Wood &Company; 1886.
14. Bearn JG. Direct observations on the function of the capsule of the sternoclavicular joint in clavicular support. J Anat 1967;101(Pt 1):159-170.
15. Cadenat FM. The treatment of dislocations and fractures of the outer end of the clavicle. Int Clin 1917;1:145-169.
16. Weaver JK, Dunn HK. Treatment of acromioclavicular injuries, especially complete acromioclavicular separation. J Bone Joint Surg Am 1972;54(6):1187-1194.
17. Wolf EM, Pennington WT. Arthroscopic reconstruction for acromioclavicular joint dislocation. Arthroscopy 2001;17(5):558-563.
18. Lancourt JE. Acromioclavicular dislocation with adjacent clavicular fracture in a horseback rider. A case report. Am J Sports Med 1990;18(3):321-322.


How to Cite this article: Sahu B, Panigrahi R, Palo N, Priyadarshi A, Samant S. Acute Complete Acromioclavicular Dislocations: A Prospective Multicenter Therapeutic Study Comparing Combined Intra-articular and Extra-articular Fixation With Intra-articular K-wire FixationTrauma International Sep-Dec 2017;3(2):21-24.



(Abstract)      (Full Text HTML)      (Download PDF)