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Clinical effectiveness of surgical treatment with polyester tapes and temporary K-wires on complete acromioclavicular dislocation

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

Abstract

Introduction

Ideal treatment of acute acromioclavicular joint (ACJ) dislocation remains unresolved. We evaluated ACJ reconstruction using polyester tapes and temporary Kirschner wire (KW) and presented clinical and radiological outcomes.

Materials and methods

Patients were retrospectively evaluated and classified according to Rockwood classification, clinical and sportive characteristics. Constant Score (CS) and ACJ joint instability (ACJI) score were collected. Zanca’s, Alexander, axillary, standard, and stress AP views were collected. Radiographic coracoclavicular distance (CCd) of healthy and injured shoulders was measured pre-operatively, at 3 months and at minimum 2-year follow-up. Heterotopic ossifications and clavicular osteolysis were evaluated. Influence of patients’ characteristics and AC joint type on clinical and radiological outcomes were determined.

Results

Sixteen patients (13 type V and 3 type III ACJ dislocation) reached the end of follow-up (mean 2.4 years; range 22–72 months). Mean CS was 99.63 (range 96–100), while the mean ACJI score was 96.19 (range 85–100). The CCd of the treated shoulder was comparable with the healthy shoulder at 3 months and at last follow-up; moreover, there was no difference in CCd scores at 3 months and at 2 years. CCd scores were lower in sedentary patients compared with physically active (sporty) patients. Heterotopic ossifications were observed in three patients. No osteolysis was reported.

Conclusion

This technique provides good results with few complications and should be considered as an effective method to treat ACJ acute dislocation. CCd scores correlate with overuse factors but not with other clinical scores.

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Authors and Affiliations

  1. Orthopedic Department, San Gerardo Hospital, University of Milano-Bicocca, Via Pergolesi 33, Monza, 20900, Italy

    Marco Bigoni, Massimiliano Piatti, Massimo Gorla, Diego Gaddi, Giovanni Zatti & Marco Turati

  2. Department of Medicine and Surgery, University of Milano-Bicocca, 20900, Monza, Italy

    Marco Bigoni, Nicolò Zanchi, Luca Rigamonti, Giovanni Zatti & Marco Turati

  3. Department of Paediatric Orthopedic Surgery, University Hospital Grenoble-Alpes, University Grenoble-Alpes, Grenoble, France

    Marco Turati

  4. Department of Biology, Lakehead University, Thunder Bay, ON, P7B5E1, Canada

    Robert J. Omeljaniuk

Authors
  1. Marco Bigoni
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  2. Massimiliano Piatti
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  3. Nicolò Zanchi
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  4. Massimo Gorla
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  5. Diego Gaddi
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  6. Luca Rigamonti
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  8. Giovanni Zatti
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  9. Marco Turati
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Corresponding author

Correspondence to Marco Turati.

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Conflict of interest

Marco Bigoni, Massimiliano Piatti, Nicolò Zanchi, Massimo Gorla, Diego Gaddi, Luca Rigamonti, Robert J. Omeljaniuk, Giovanni Zatti, and Marco Turati declare that they have no conflict of interest.

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Bigoni, M., Piatti, M., Zanchi, N. et al. Clinical effectiveness of surgical treatment with polyester tapes and temporary K-wires on complete acromioclavicular dislocation. Eur J Orthop Surg Traumatol 29, 567–573 (2019). https://doi.org/10.1007/s00590-018-2321-9

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  • DOI: https://doi.org/10.1007/s00590-018-2321-9

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