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Acromioclavicular joint dislocation: a Dog Bone button fixation alone versus Dog Bone button fixation augmented with acromioclavicular repair—a finite element analysis study

  • Original Article • SHOULDER - ARTHROSCOPY
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Background

Suspension suture button fixation was frequently used to treat acromioclavicular joint (ACJ) dislocation. However, there were many studies reporting about complications and residual horizontal instability after fixation. Our study compared the stability of ACJ after fixation between coracoclavicular (CC) fixation alone and CC fixation combined with ACJ repair by using finite element analysis (FEA).

Materials and methods

A finite element model was created by using CT images from the normal shoulder. The model 1 was CC fixation with suture button alone, and the model 2 was CC fixation with suture button combined with ACJ repair. Three different forces (50, 100, 200 N) applied to the model in three planes; inferior, anterior and posterior direction load to the acromion. The von Mises stress of the implants and deformation at ACJs was recorded.

Results

The ACJ repair in the model 2 could reduce the peak stress on the implant after applying the loading forces to the acromion which the ACJ repair could reduce the peak stress of the FiberWire at suture button about 90% when compared to model 1. And, the ACJ repair could reduce the deformation of the ACJ after applying the loading forces to the acromion in both vertical and horizontal planes.

Conclusion

This FEA supports that the high-grade injuries of the ACJ should be treated with CC fixation combined with ACJ repair because this technique provides excellent stability in both vertical and horizontal planes and reduces stress to the suture button.

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Acknowledgements

All authors declare no funding source or sponsor involvement in the study design, collection, analysis and interpretation of the data, in writing the manuscript, and in submission of the manuscript for publication.

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Authors and Affiliations

  1. Department of Orthopedics, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand

    Sermsak Sumanont, Artit Boonrod & Punyawat Apiwatanakul

  2. Department of Orthopedic Surgery, Kalasin Hospital, Kalasin, Thailand

    Supachoke Nopamassiri

  3. Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand

    Arunnit Boonrod

  4. Department of Orthopedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand

    Chanakarn Phornphutkul

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  1. Sermsak Sumanont
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  2. Supachoke Nopamassiri
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  3. Artit Boonrod
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  4. Punyawat Apiwatanakul
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  5. Arunnit Boonrod
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  6. Chanakarn Phornphutkul
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Correspondence to Artit Boonrod.

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Sumanont, S., Nopamassiri, S., Boonrod, A. et al. Acromioclavicular joint dislocation: a Dog Bone button fixation alone versus Dog Bone button fixation augmented with acromioclavicular repair—a finite element analysis study. Eur J Orthop Surg Traumatol 28, 1095–1101 (2018). https://doi.org/10.1007/s00590-018-2186-y

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  • DOI: https://doi.org/10.1007/s00590-018-2186-y

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