Abstract
After reconstruction of the coracoclavicular ligament on patients with complete separation of the acromioclavicular joint (Rockwood's classification III or V ), a residual subluxation is often found. We performed the modified Cadenat procedure on these patients, and investigated the distance between the clavicle and the coracoid process (C-C distance). The thirty-five patients; thirty-one males and four females, average age thirty-five years old, had reconstruction of coracoclavicular ligament. As a temporary fixation, Kirschner's wire (K) was used in twentythree patients and Wolter-clavicular plate (W) in twelve patients. We evaluated the therapeutic results more than nine months postoperatively. Using anteroposterior roentgenographic views, the C-C distances were measured, and we classified them into two groups based on the preoperative C-C distance, Group A (125 to 200% more than non-affected side) and Group B (over 200%). The postoperative C-C distance of each group more than nine months was respectively investigated. The therapeutic results were evaluated based on the criteria of JSS A-C joint dislocation score (total 90 points). The average of postoperative C-C distance was Group A,105.5% (K: 110.9%, W: 97.5%); and Group B,138.5% (K: 144.2%, W: 117.8%) respectively. The residual subluxation was found in Group A, two patients (K: 2, W: 0); and Group B, six patients (K: 5, W: 1). The average of JSS A-C joint dislocation score was Group A,85.7 points; and Group B,85.3 points. We should consider the temporary fixation to keep the anatomical position based on the C-C distance. Of these cases following a strong separation and soft tissue injury, we considered a certain temporary fixation using a plate to be significant.
