Marco Bigoni1,2, Massimiliano Piatti1, Nicolò Zanchi2, Massimo Gorla1, Diego Gaddi1, Luca Rigamonti2, Robert J Omeljaniuk3, Giovanni Zatti1,2, Marco Turati4,5,6. 1. Orthopedic Department, San Gerardo Hospital, University of Milano-Bicocca, Via Pergolesi 33, Monza, 20900, Italy. 2. Department of Medicine and Surgery, University of Milano-Bicocca, 20900, Monza, Italy. 3. Department of Biology, Lakehead University, Thunder Bay, ON, P7B5E1, Canada. 4. Orthopedic Department, San Gerardo Hospital, University of Milano-Bicocca, Via Pergolesi 33, Monza, 20900, Italy. turati.mrc@gmail.com. 5. Department of Medicine and Surgery, University of Milano-Bicocca, 20900, Monza, Italy. turati.mrc@gmail.com. 6. Department of Paediatric Orthopedic Surgery, University Hospital Grenoble-Alpes, University Grenoble-Alpes, Grenoble, France. turati.mrc@gmail.com.
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.
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.