K Rehbein1, C Jung, U Becker, G Bauer. 1. Orthopädie/Unfallchirurgie/Sportmedizin, Sportklinik Stuttgart. klaudia.rehbein@googlemail.com
Abstract
AIM: Many different procedures are used for the operative treatment of acute AC joint dislocations type Rockwood III - VI. We discuss the clinical results for an exact anatomical reconstruction of the AC-joint by transosseal acromioclavicular and coracoclavicular FiberWire cerclage. METHOD: 56 patients with acute AC joint dislocations type Rockwood III and V underwent operative treatment, using an exact anatomical reconstruction of the AC joint by transosseal acromioclavicular and coracoclavicular FiberWire cerclage. A clinical and radiological follow-up examination was performed. Clinical complications, objective results, radiological results, Constant and Rowe scores were evaluated. RESULTS: 43 patients could be examined on average 15.4 months after surgery. 24 patients (56 %) showed radiological signs of ossification of the acromioclavicular and coracoclavicular ligaments. Minimal postoperative clavicular displacement was observed in 14 patients (33 %). 2 patients (5 %) needed a second surgery due to complications, in one case because of reduction in the range of motion, in the other case due to abacterial inflammation. The advantage of this type of surgery is a minimal rate of complications and a good objective result with a high Constant score of 94 and Rowe score of 93, without the need for a second surgery. CONCLUSION: This procedure for an exact anatomic AC joint reconstruction shows good objective results with a high Constant and Rowe scores for shoulder function. Postoperative ossifications of the AC joint ligaments are common, but seem to have no influence on the clinical results.
AIM: Many different procedures are used for the operative treatment of acute AC joint dislocations type Rockwood III - VI. We discuss the clinical results for an exact anatomical reconstruction of the AC-joint by transosseal acromioclavicular and coracoclavicular FiberWire cerclage. METHOD: 56 patients with acute AC joint dislocations type Rockwood III and V underwent operative treatment, using an exact anatomical reconstruction of the AC joint by transosseal acromioclavicular and coracoclavicular FiberWire cerclage. A clinical and radiological follow-up examination was performed. Clinical complications, objective results, radiological results, Constant and Rowe scores were evaluated. RESULTS: 43 patients could be examined on average 15.4 months after surgery. 24 patients (56 %) showed radiological signs of ossification of the acromioclavicular and coracoclavicular ligaments. Minimal postoperative clavicular displacement was observed in 14 patients (33 %). 2 patients (5 %) needed a second surgery due to complications, in one case because of reduction in the range of motion, in the other case due to abacterial inflammation. The advantage of this type of surgery is a minimal rate of complications and a good objective result with a high Constant score of 94 and Rowe score of 93, without the need for a second surgery. CONCLUSION: This procedure for an exact anatomic AC joint reconstruction shows good objective results with a high Constant and Rowe scores for shoulder function. Postoperative ossifications of the AC joint ligaments are common, but seem to have no influence on the clinical results.
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