The results of coraco-clavicular slings for acromio-clavicular dislocation.
BACKGROUND
Treatment of type 3 acromio-clavicular (A-C) dislocations is controversial. There have been over 60 different surgical procedures as well as a variety of conservative measures used to treat this injury.


METHODS
The outcome of a coraco-clavicular (C-C) sling for grade 3-4 A-C dislocation was studied. A dissolvable sling of braided 1 polydioxanone (PDS, Ethicon) was used with or without excision of the distal end of the clavicle in six patients. The clinical and radiological outcome of the braid and acromio-clavicular joint were studied by clinical examination, plain and stress radiographs and magnetic resonance imaging (MRI).


RESULTS
All patients reported good-excellent results from 6 months after surgery. Radiological examination demonstrated some superior clavicular migration in all patients within 1 month of the procedure, although never more than that seen with a grade 2 dislocation. This migration was clinically evident only in patients with a thin build. At 1 month, the MRI demonstrated partial replacement of the braid by granulation tissue. From 6 months on, the braid was absent and fibrous tissue was noted between the coracoid and the clavicle and the acromion and clavicle.


CONCLUSIONS
The coraco-clavicular sling did not maintain operative reduction of the dislocated clavicle. This did not diminish the functional result but was a cosmetic complication in patients with a thin build.
Clayer
M
M
Department of Orthopaedic Surgery, Flinders Medical Centre, Bedford Park, Australia.
Slavotinek
J
J
Krishnan
J
J
D000173:Acromioclavicular Joint / Q000293:injuries*; D016267:External Fixators; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016268:Internal Fixators / Q000009:adverse effects / Q000592:standards*; D004204:Joint Dislocations / Q000145:classification / Q000000981:diagnostic imaging / Q000601:surgery*; D008023:Ligaments, Articular / Q000293:injuries*; D008279:Magnetic Resonance Imaging; D008297:Male; D011859:Radiography; D012421:Rupture; D013536:Suture Techniques; D016896:Treatment Outcome