Acromioclavicular reconstruction augmented with polydioxanonsulphate bands. Surgical technique and results.
During a 5.5-year period, we treated 64 patients with acute acromioclavicular separations by surgical reconstruction. According to the classification of Rockwood and Matsen, 54 patients had type III lesions, 1 patient had a type IV lesion, and 9 patients had type V lesions. Both the coracoclavicular ligaments and the ligaments of the acromioclavicular joint were reconstructed. An additional ligamentous augmentation was performed using completely resorbable 5- and 10-mm polydioxanonsulphate bands. Forty-five patients (70%) were re-examined at 2 to 7.5 years after surgery (mean, 32 months). The results were good or excellent in 40 cases (89%). Forty-one patients (92%) achieved a range of motion with an abduction deficit of less than 20 degrees. Calcifications in the area of the coracoclavicular or acromioclavicular ligaments did not affect the final range of motion. Complications consisted of one subcutaneous infection, one deep infection, and one failure of the reconstruction. Augmenting the reconstruction with polydioxanonsulphate bands allowed an early functional postoperative treatment. With this procedure, patients do not require removal of an implant, and complications from breakage or migration of metal implants are avoided.
Department for Traumatology, Philipps-University, Marburg, Germany.
M
M
Hessmann
L
L
Gotzen
H
H
Gehling
D000173:Acromioclavicular Joint / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain; D016687:Polydioxanone; D011183:Postoperative Complications; D011859:Radiography; D016059:Range of Motion, Articular; D013536:Suture Techniques; D013537:Sutures; D016896:Treatment Outcome; D016474:Weight-Bearing
D016687:Polydioxanone