Effectiveness of arthroscopic assisted double Endobutton “8” buckle fixation in treatment of Rockwood <b>Ⅲ</b> type acute acromioclavicular joint dislocation_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

DENG Fuyuan , LI Zhong ,  LIU Juncai

Department of Orthopedics, the Affiliated Hospital of Southwest Medical University, Luzhou Sichuan, 646000, P.R.China;

Corresponding?author：

LIU Juncai, Email: ljc125520@163.com

Keywords：

Arthroscopy; Rockwood Ⅲ type; acromioclavicular joint dislocation; Endobutton plate; internal fixation

DOI：

10.7507/1002-1892.202002117

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Objective To investigate the short-term effectiveness of arthroscopic assisted double Endobutton “8” buckle fixation in the treatment of Rockwood Ⅲ type acute acromioclavicular joint dislocation.Methods The clinical data of 12 patients with Rockwood Ⅲ type acute acromioclavicular joint dislocation who were treated with arthroscopic assisted double Endobutton “8” buckle fixation between June 2016 and June 2019 were analyzed retrospectively. There were 8 males and 4 females, with an average age of 47.0 years (range, 36-58 years). There were 4 cases of left shoulder and 8 cases of right shoulder. The causes of injury included traffic accident injury in 7 cases and falling injury in 5 cases. The average time from injury to operation was 5.0 days (range, 3-14 days). Before operation and at last follow-up, the shoulder joint activity was recorded; the improvements of function and pain were evaluated by Constant score and visual analogue scale (VAS) score, respectively; the reduction was evaluated by measuring the coracoid spacing of the affected side on the anteroposterior X-ray film of shoulder joint.Results All 12 cases were followed up 6-36 months, with an average of 20.6 months. All the incisions healed by first intention. There was no complications such as clavicle and coracoid fractures and Endobuton displacement. At last follow-up, the range of motion of the abduction improved from preoperative (77.5±4.5)° to (162.5±6.5)°, the range of motion of forward flexion improved from (84.1±5.2)° to (169.5±5.8)°, the Constant score improved from 42.5±2.3 to 92.4±2.3, the VAS score improved from 5.4±0.8 to 0.6±0.5, and the coracoid spacing reduced from (20.5±1.4) mm to (9.2±0.6) mm, all showing significant differences (P<0.05).Conclusion Arthroscopic assisted double Endobutton “8” buckle fixation for the treatment of Rockwood Ⅲ type acute acromioclavicular joint dislocation is safe, less invasive, and quicker recovery. It can effectively alleviate shoulder pain, significantly improve the mobility of the shoulder joint, and achieve good short-term effectiveness.

Citation： DENG Fuyuan, LI Zhong, LIU Juncai. Effectiveness of arthroscopic assisted double Endobutton “8” buckle fixation in treatment of Rockwood Ⅲ type acute acromioclavicular joint dislocation. Chinese Journal of Reparative and Reconstructive Surgery, 2020, 34(9): 1125-1129. doi: 10.7507/1002-1892.202002117 Copy

1.	Wang G, Xie R, Mao T, et al. Treatment of AC dislocation by reconstructing CC and AC ligaments with allogenic tendons compared with hook plates. J Orthop Surg Res, 2018, 13(1): 175.
2.	Seijas R, Sallent A, Ares O. Rockwood type Ⅲ acromioclavicular joint dislocation; Are we still fighting? J Invest Surg, 2018, 31(3): 234-235.
3.	Longo UG, Ciuffreda M, Rizzello G, et al. Surgical versus conservative management of type Ⅲ acromioclavicular dislocation: A systematic review. Br Med Bull, 2017, 122(1): 31-49.
4.	Smith TO, Chester R, Pearse EO, et al. Operative versus non-operative management following rockwood grade Ⅲ acromioclavicular separation: A meta-analysis of the current evidence base. J Orthop Traumatol, 2011, 12(1): 19-27.
5.	Allemann F, Halvachizadeh S, Waldburger M, et al. Different treatment strategies for acromioclavicular dislocation injuries: a nationwide survey on open/minimally invasive and arthroscopic concepts. Eur J Med Res, 2019, 24(1): 18.
6.	Carbone S, Postacchini R, Gumina S. Scapular dyskinesis and SICK syndrome in patients with a chronic type Ⅲ acromioclavicular dislocation. Results of rehabilitation. Knee Surg Sports Traumatol Arthrosc, 2015, 23(5): 1473-1480.
7.	Mouhsine E, Garofalo R, Crevoisier X, et al. Grade I and Ⅱ acromioclavicular dislocations: results of conservative treatment. J Shoulder Elbow Surg, 2003, 12(6): 599-602.
8.	Babhulkar A, Pawaskar A. Acromioclavicular joint dislocations. Curr Rev Musculoskelet Med, 2014, 7(1): 33-39.
9.	Lizaur A, Sanz-Reig J, Gonzalez-Parre?o S. Long-term results of the surgical treatment of type Ⅲ acromioclavicular dislocations: an update of a previous report. J Bone Joint Surg (Br), 2011, 93(8): 1088-1092.
10.	Loriaut P, Casabianca L, Alkhaili J, et al. Arthroscopic treatment of acute acromioclavicular dislocations using a double button device: clinical and MRI results. Orthop Traumatol Surg Res, 2015, 101(8): 895-901.
11.	Braun S, Imhoff AB, Martetschl?ger F. Arthroscopically assisted techniques for treatment of acute and chronic acromioclavicular joint injuries. Unfallchirurg, 2015, 118(5): 407-414.
12.	Virtanen KJ, Remes VM, Tulikoura IT, et al. Surgical treatment of rockwood grade-Ⅴ acromioclavicular joint dislocations: 50 patients followed for 15-22 years. Acta Orthop, 2013, 84(2): 191-195.
13.	Lin HY, Wong PK, Ho WP, et al. Clavicular hook plate may induce subacromial shoulder impingement and rotator cuff lesion—dynamic sonographic evaluation. J Orthop Surg Res, 2014, 9: 6.
14.	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, 2016, 24(6): 1918-1924.
15.	Struhl S. Double endobutton technique for repair of complete acromioclavicular joint dislocations. Tech Shoulder Elbow Surg, 2007, 8(4): 175-179.
16.	Teodoro RL, Nishimi AY, Pascarelli L, et al. Surgical treatment of acromioclavicular dislocation using the endobutton. Acta Ortop Bras, 2017, 25(3): 81-84.
17.	Natera-Cisneros L, Sarasquete-Reiriz J, Escolà-Benet A, et al. Acute high-grade acromioclavicular joint injuries treatment: arthroscopic non-rigid coracoclavicular fixation provides better quality of life outcomes than hook plate ORIF. Orthop Traumatol Surg Res, 2016, 102(1): 31-39.
18.	Stein T, Müller D, Blank M, et al. Stabilization of acute high-grade acromioclavicular joint separation: A prospective assessment of the clavicular hook plate versus the double double-button suture procedure. Am J Sports Med, 2018, 46(11): 2725-2734.
19.	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.
20.	Scheibel M, Dr?schel S, Gerhardt C, et al. Arthroscopically assisted stabilization of acute high-grade acromioclavicular joint separations. Am J Sports Med, 2011, 39(7): 1507-1516.
21.	王超然, 張俊, 陳鴻, 等. 全關節鏡下 Twin Tail TightRope 結合遠端關節囊修復技術治療急性肩鎖關節脫位. 中國修復重建外科雜志, 2019, 33(8): 970-975.
22.	姚曉克, 伍玲娜, 李建華, 等. 切開復位內固定治療合并喙突骨折的上肩胛懸吊復合體多重損傷. 中國修復重建外科雜志, 2020, 34(3): 347-351.

1. Wang G, Xie R, Mao T, et al. Treatment of AC dislocation by reconstructing CC and AC ligaments with allogenic tendons compared with hook plates. J Orthop Surg Res, 2018, 13(1): 175.
2. Seijas R, Sallent A, Ares O. Rockwood type Ⅲ acromioclavicular joint dislocation; Are we still fighting? J Invest Surg, 2018, 31(3): 234-235.
3. Longo UG, Ciuffreda M, Rizzello G, et al. Surgical versus conservative management of type Ⅲ acromioclavicular dislocation: A systematic review. Br Med Bull, 2017, 122(1): 31-49.
4. Smith TO, Chester R, Pearse EO, et al. Operative versus non-operative management following rockwood grade Ⅲ acromioclavicular separation: A meta-analysis of the current evidence base. J Orthop Traumatol, 2011, 12(1): 19-27.
5. Allemann F, Halvachizadeh S, Waldburger M, et al. Different treatment strategies for acromioclavicular dislocation injuries: a nationwide survey on open/minimally invasive and arthroscopic concepts. Eur J Med Res, 2019, 24(1): 18.
6. Carbone S, Postacchini R, Gumina S. Scapular dyskinesis and SICK syndrome in patients with a chronic type Ⅲ acromioclavicular dislocation. Results of rehabilitation. Knee Surg Sports Traumatol Arthrosc, 2015, 23(5): 1473-1480.
7. Mouhsine E, Garofalo R, Crevoisier X, et al. Grade I and Ⅱ acromioclavicular dislocations: results of conservative treatment. J Shoulder Elbow Surg, 2003, 12(6): 599-602.
8. Babhulkar A, Pawaskar A. Acromioclavicular joint dislocations. Curr Rev Musculoskelet Med, 2014, 7(1): 33-39.
9. Lizaur A, Sanz-Reig J, Gonzalez-Parre?o S. Long-term results of the surgical treatment of type Ⅲ acromioclavicular dislocations: an update of a previous report. J Bone Joint Surg (Br), 2011, 93(8): 1088-1092.
10. Loriaut P, Casabianca L, Alkhaili J, et al. Arthroscopic treatment of acute acromioclavicular dislocations using a double button device: clinical and MRI results. Orthop Traumatol Surg Res, 2015, 101(8): 895-901.
11. Braun S, Imhoff AB, Martetschl?ger F. Arthroscopically assisted techniques for treatment of acute and chronic acromioclavicular joint injuries. Unfallchirurg, 2015, 118(5): 407-414.
12. Virtanen KJ, Remes VM, Tulikoura IT, et al. Surgical treatment of rockwood grade-Ⅴ acromioclavicular joint dislocations: 50 patients followed for 15-22 years. Acta Orthop, 2013, 84(2): 191-195.
13. Lin HY, Wong PK, Ho WP, et al. Clavicular hook plate may induce subacromial shoulder impingement and rotator cuff lesion—dynamic sonographic evaluation. J Orthop Surg Res, 2014, 9: 6.
14. 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, 2016, 24(6): 1918-1924.
15. Struhl S. Double endobutton technique for repair of complete acromioclavicular joint dislocations. Tech Shoulder Elbow Surg, 2007, 8(4): 175-179.
16. Teodoro RL, Nishimi AY, Pascarelli L, et al. Surgical treatment of acromioclavicular dislocation using the endobutton. Acta Ortop Bras, 2017, 25(3): 81-84.
17. Natera-Cisneros L, Sarasquete-Reiriz J, Escolà-Benet A, et al. Acute high-grade acromioclavicular joint injuries treatment: arthroscopic non-rigid coracoclavicular fixation provides better quality of life outcomes than hook plate ORIF. Orthop Traumatol Surg Res, 2016, 102(1): 31-39.
18. Stein T, Müller D, Blank M, et al. Stabilization of acute high-grade acromioclavicular joint separation: A prospective assessment of the clavicular hook plate versus the double double-button suture procedure. Am J Sports Med, 2018, 46(11): 2725-2734.
19. 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.
20. Scheibel M, Dr?schel S, Gerhardt C, et al. Arthroscopically assisted stabilization of acute high-grade acromioclavicular joint separations. Am J Sports Med, 2011, 39(7): 1507-1516.
21. 王超然, 張俊, 陳鴻, 等. 全關節鏡下 Twin Tail TightRope 結合遠端關節囊修復技術治療急性肩鎖關節脫位. 中國修復重建外科雜志, 2019, 33(8): 970-975.
22. 姚曉克, 伍玲娜, 李建華, 等. 切開復位內固定治療合并喙突骨折的上肩胛懸吊復合體多重損傷. 中國修復重建外科雜志, 2020, 34(3): 347-351.

Chinese Journal of Reparative and Reconstructive Surgery

Effectiveness of arthroscopic assisted double Endobutton “8” buckle fixation in treatment of Rockwood Ⅲ type acute acromioclavicular joint dislocation

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