COMPARISON OF EFFECTIVENESS BETWEEN TWO OPERATIVE TECHNIQUES OF CORACOCLAVICULAR LIGAMENT RECONSTRUCTION FOR TREATMENT OF Tossy TYPE Ⅲ ACROMIOCLAVICULAR JOINT DISLOCATION_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 TANGHongwei , GAOSheng , YINYong , LIYunfei , HANQingtian , LIHuizhang

Department of Orthopaedics, Jiading Center Hospital, Shanghai, 201800, P. R. China;

Corresponding?author：

TANGHongwei, Email: thwgmy@hotmail.com

Keywords：

Acromioclavicular joint dislocation; Ligament reconstruction; Endobutton technique; Suture anchor

DOI：

10.7507/1002-1892.20150286

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate and compare the effectiveness of double Endobutton technique and suture anchor combined Endobutton plate in the treatment of Tossy type Ⅲ acromioclavicular joint dislocation. Methods Between May 2010 and March 2014, a retrospective study was preformed on 56 patients with Tossy type Ⅲ acromioclavicular joint dislocation. The coracoclavicular ligament was reconstructed with double Endobutton technique in 31 cases (Endobutton group), and with suture anchor combined Endobutton plate in 25 cases (Anchor group). There was no significant difference in age, gender, injury causes, injury side, associated injury, medical comorbidities, and disease duration between 2 groups (P>0.05). The operation time, medical device expenses, postoperative complications, preoperative and postoperative Constant-Murley scores, and postoperative Karlsson grading of the injured shoulder were compared between 2 groups. Results The average operation time in Endobutton group was significantly greater than that in Anchor group (t=4.285, P=0.000); there was no significant difference in the medical device expenses between 2 groups (t=1.555, P=0.126). Primary healing of incision was obtained in all patients of 2 groups; no early complications of infection and skin necrosis occurred. All patients were followed up 15.6 months on average (range, 11-35 months). During follow-up, some loss of reduction and ectopic ossification in the coracoclavicular gap were observed in 1 case and 6 cases of Endobutton group, respectively. No recurrence of acromioclavicular joint dislocation, implant fixation loosening and broken, and secondary fractures occurred in the other patients. There was significant difference in the incidence of postoperative complications between 2 groups (P=0.013). Constant-Murley scores of the injured shoulder significantly increased at 9 months after operation when compared with preoperative values in 2 groups (P<0.05), but no significant difference was observed between 2 groups (P>0.05). At last follow-up, there was no significant difference in Karlsson grading between 2 groups (Z=-0.628, P=0.530). Conclusion Both double Endobutton technique and suture anchor combined Endobutton plate have good effectiveness in the treatment of Tossy type Ⅲ acromioclavicular joint dislocation. But the latter is associated with easier operation, less operation time, and less complications.

Citation： TANGHongwei, GAOSheng, YINYong, LIYunfei, HANQingtian, LIHuizhang. COMPARISON OF EFFECTIVENESS BETWEEN TWO OPERATIVE TECHNIQUES OF CORACOCLAVICULAR LIGAMENT RECONSTRUCTION FOR TREATMENT OF Tossy TYPE Ⅲ ACROMIOCLAVICULAR JOINT DISLOCATION. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(11): 1321-1326. doi: 10.7507/1002-1892.20150286 Copy

1.	Ma R, Smith PA, Smith MJ, et al. Managing and recognizing complications after treatment of acromioclavicular joint repair or reconstruction. Curr Rev Musculoskelet Med, 2015, 8(1):75-82.
2.	胥少汀, 葛寶豐, 徐印坎. 實用骨科學. 4版. 北京:人民軍醫出版社, 2012:526.
3.	Beitzel K, Cote MP, Apostolakos J, et al. Current concepts in the treatment of acromioclavicular joint dislocations. Arthroscopy, 2013, 29(2):387-397.
4.	Constant CR, Murley AH. A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res, 1987, (214):160-164.
5.	Karlsson J, Arnarson H, Sigurjónsson K. Acromioclavicular dislocations treated by coraocoacromial oligament transfer. Arch Orthop Trauma Surg, 1986, 106(1):8-11.
6.	Stucken C, Cohen SB. Management of acromioclavicular joint injuries. Orthop Clin North Am, 2015, 46(1):57-66.
7.	von Heideken J, Bostr?m Windhamre H, Une-Larsson V, et al. Acute surgical treatment of acromioclavicular dislocation type V with a hook plate:superiority to late reconstruction. J Shoulder Elbow Surg, 2013, 22(1):9-17.
8.	王朝亮, 王英振, 朱濤, 等. 鎖骨鉤鋼板聯合斜方肌筋膜瓣重建肩鎖韌帶及喙鎖韌帶治療肩鎖關節脫位. 中國修復重建外科雜志, 2015, 29(2):149-153.
9.	Tauber M. Management of acute acromioclavicular joint dislocations:current concepts. Arch Orthop Trauma Surg, 2013, 133(7):985-995.
10.	Li H, Wang C, Wang J, et al. Restoration of horizontal stability in complete acromioclavicular joint separations:surgical technique and preliminary results. Eur J Med Res, 2013, 18:42.
11.	Nuchtern JV, Sellenschloh K, Bishop N, et al. Biomechanical evaluation of 3 stabilization methods on acromioclavicular joint dislocations. Am J Sports Med, 2013, 41(6):1387-1394.
12.	Grantham C, Heckmann N, Wang L, et al. A biomechanical assessment of a novel double endobutton technique versus a coracoid cerclage sling for acromioclavicular and coracoclavicular injuries. Knee Surg Sports Traumatol Arthrosc, 2014.[Epub ahead of print].
13.	Struhl S. Double endobutton technique for repair of complete acromioclavicular joint dislocations. Tech Shoulder Elbow Surg, 2007, 8(4):175-179.
14.	Pan Z, Zhang H, Sun C, et al. Arthroscopy-assisted reconstruction of coracoclavicular ligament by Endobutton fixation for treatment of acromioclavicular joint dislocation. Arch Orthop Trauma Surg, 2015, 135(1):9-16.
15.	胡曉波, 蔣電明, 陽明明, 等. 雙帶袢紐扣鋼板與鎖骨鉤鋼板治療Tossy Ⅲ型肩鎖關節脫位的療效評價. 中華創傷雜志, 2014, 30(10):1009-1013.
16.	郝亮, 廖琦, 周斌, 等. C臂X線機引導下雙Endobutton鋼板微創治療肩鎖關節脫位. 中國修復重建外科雜志, 2014, 28(7):919-920.
17.	安維軍, 孫建斌, 葉鵬, 等. 喙鎖韌帶重建聯合鉤鋼板固定或縫合錨固定治療肩鎖關節脫位的對比研究. 中華外科雜志, 2013, 51(4):349-353.
18.	Zhang JW, Li M, He XF, et al. Operative treatment of acromioclavicular joint dislocation:a new technique with suture anchors. Chin J Traumatol, 2014, 17(4):187-192.
19.	王鵬飛, 魏星, 莊嚴, 等. 應用錨釘治療Rockwood Ⅲ型肩鎖關節脫位臨床療效觀察. 中國骨與關節損傷雜志, 2013, 28(3):264-265.
20.	Ladermann A, Gueorguiev B, Stimec B, et al. Acromioclavicular joint reconstruction:a comparative biomechanical study of three techniques. J Shoulder Elbow Surg, 2013, 22(2):171-178.
21.	Milewski MD, Tompkins M, Giugale JM, et al. Complications related to anatomic reconstruction of the coracoclavicular ligaments. Am J Sports Med, 2012, 40(7):1628-1634.

1. Ma R, Smith PA, Smith MJ, et al. Managing and recognizing complications after treatment of acromioclavicular joint repair or reconstruction. Curr Rev Musculoskelet Med, 2015, 8(1):75-82.
2. 胥少汀, 葛寶豐, 徐印坎. 實用骨科學. 4版. 北京:人民軍醫出版社, 2012:526.
3. Beitzel K, Cote MP, Apostolakos J, et al. Current concepts in the treatment of acromioclavicular joint dislocations. Arthroscopy, 2013, 29(2):387-397.
4. Constant CR, Murley AH. A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res, 1987, (214):160-164.
5. Karlsson J, Arnarson H, Sigurjónsson K. Acromioclavicular dislocations treated by coraocoacromial oligament transfer. Arch Orthop Trauma Surg, 1986, 106(1):8-11.
6. Stucken C, Cohen SB. Management of acromioclavicular joint injuries. Orthop Clin North Am, 2015, 46(1):57-66.
7. von Heideken J, Bostr?m Windhamre H, Une-Larsson V, et al. Acute surgical treatment of acromioclavicular dislocation type V with a hook plate:superiority to late reconstruction. J Shoulder Elbow Surg, 2013, 22(1):9-17.
8. 王朝亮, 王英振, 朱濤, 等. 鎖骨鉤鋼板聯合斜方肌筋膜瓣重建肩鎖韌帶及喙鎖韌帶治療肩鎖關節脫位. 中國修復重建外科雜志, 2015, 29(2):149-153.
9. Tauber M. Management of acute acromioclavicular joint dislocations:current concepts. Arch Orthop Trauma Surg, 2013, 133(7):985-995.
10. Li H, Wang C, Wang J, et al. Restoration of horizontal stability in complete acromioclavicular joint separations:surgical technique and preliminary results. Eur J Med Res, 2013, 18:42.
11. Nuchtern JV, Sellenschloh K, Bishop N, et al. Biomechanical evaluation of 3 stabilization methods on acromioclavicular joint dislocations. Am J Sports Med, 2013, 41(6):1387-1394.
12. Grantham C, Heckmann N, Wang L, et al. A biomechanical assessment of a novel double endobutton technique versus a coracoid cerclage sling for acromioclavicular and coracoclavicular injuries. Knee Surg Sports Traumatol Arthrosc, 2014.[Epub ahead of print].
13. Struhl S. Double endobutton technique for repair of complete acromioclavicular joint dislocations. Tech Shoulder Elbow Surg, 2007, 8(4):175-179.
14. Pan Z, Zhang H, Sun C, et al. Arthroscopy-assisted reconstruction of coracoclavicular ligament by Endobutton fixation for treatment of acromioclavicular joint dislocation. Arch Orthop Trauma Surg, 2015, 135(1):9-16.
15. 胡曉波, 蔣電明, 陽明明, 等. 雙帶袢紐扣鋼板與鎖骨鉤鋼板治療Tossy Ⅲ型肩鎖關節脫位的療效評價. 中華創傷雜志, 2014, 30(10):1009-1013.
16. 郝亮, 廖琦, 周斌, 等. C臂X線機引導下雙Endobutton鋼板微創治療肩鎖關節脫位. 中國修復重建外科雜志, 2014, 28(7):919-920.
17. 安維軍, 孫建斌, 葉鵬, 等. 喙鎖韌帶重建聯合鉤鋼板固定或縫合錨固定治療肩鎖關節脫位的對比研究. 中華外科雜志, 2013, 51(4):349-353.
18. Zhang JW, Li M, He XF, et al. Operative treatment of acromioclavicular joint dislocation:a new technique with suture anchors. Chin J Traumatol, 2014, 17(4):187-192.
19. 王鵬飛, 魏星, 莊嚴, 等. 應用錨釘治療Rockwood Ⅲ型肩鎖關節脫位臨床療效觀察. 中國骨與關節損傷雜志, 2013, 28(3):264-265.
20. Ladermann A, Gueorguiev B, Stimec B, et al. Acromioclavicular joint reconstruction:a comparative biomechanical study of three techniques. J Shoulder Elbow Surg, 2013, 22(2):171-178.
21. Milewski MD, Tompkins M, Giugale JM, et al. Complications related to anatomic reconstruction of the coracoclavicular ligaments. Am J Sports Med, 2012, 40(7):1628-1634.

Next Article
SURGICAL HIP DISLOCATION APPROACH FOR TREATMENT OF FEMORAL HEAD FRACTURE

Chinese Journal of Reparative and Reconstructive Surgery

COMPARISON OF EFFECTIVENESS BETWEEN TWO OPERATIVE TECHNIQUES OF CORACOCLAVICULAR LIGAMENT RECONSTRUCTION FOR TREATMENT OF Tossy TYPE Ⅲ ACROMIOCLAVICULAR JOINT DISLOCATION

Abstract Full text Figures/Tables Video References Cited by

Next Article

Format

Content