Surgical Results of Acute Acromioclavicular Joint Dislocation
-Radiological Comparison of 5 Techniques-

Abstract

The purpose of this study was to retrospectively analyze surgical results of acute acromioclavicular joint dislocation compairing with 5 different techniques. Sixty-seven patients were operated on using 5 techniques as follows; 1) simple K-wire transfixation of ACj ( Phemister procedure ) ; 10 patients, 2) K-wire transfixation with the coracoclavicular ( CC ) ligament repair (modified Phemister procedure) ; 9 patients, 3) K-wire transfixation with CC ligament reconstruction by the coracoacromial ligament transfer (modified Cadenat procedure) ; 12 patients, 4) simple Hook plate fixation ; 23 patients, 5) Hook plate fixation with the CC ligament repair ; 13 patients. Preoperative dislocation after Rockwood's classification were Type III ; 41 patients, Type IV ; 1 patient, and Type V ; 25 patients. The distance between the inferior margin of acromion and clavicle (AC distance) was measured on A-P view of plain X-ray before and after surgery, and at the final follow up. Results of the average AC distance before and after primary surgery, and at the final follow up were as follows ; 1) Phemister procedure : 12.2 ± 3.4mm, 1.4 ± 2.3mm, 8.9 ± 3.8mm respectively, 2) modified Phemister procedure : 13.5 ± 3.7mm, -0.4 ± 0.7mm, 4.5 ± 3.1mm, 3) modified Cadenat procedure : 15.4 ± 4.2mm, -1.1 ± 2.6mm, 5.0 ± 3.1mm, 4) simple Hook plate fixation : 13.8 ± 3.3mm, -2.5 ± 2.4mm, 0.5 ± 2.6mm, 5) Hook plate fixation with the CC ligament repair : 12.7 ± 3.7mm, -2.5 ± 2.1mm, 0.2 ± 1.3mm. From the point of upward migration at the final follow up, Hook plate fixation with or without the CC ligament repair showed significantly better results than simple K-wire fixation and K-wire fixation with the CC ligament repair or reconstruction.