Acromioclavicular and coracoclavicular cerclage reconstruction for acute acromioclavicular joint dislocations.
BACKGROUND
Little information is available on the results of the different stabilization techniques described for treatment of acute acromioclavicular (AC) joint injuries. Additionally, no studies have analyzed isometric performance of the shoulder after AC stabilization. The objective of our study was to present functional outcome including isokinetic testing and radiographic evaluation of patients treated with stabilization of AC joint dislocations.


METHODS
Thirty-seven patients with acute type III to V AC joint disruption underwent open coracoclavicular (CC) and AC stabilization with nonabsorbable sutures.


RESULTS
The mean follow-up was 4.5 ± 2.5 years (range, 2-10.5). The mean Constant score (CS) was 96. There were 34 (91.9%) excellent results, 1 good (2.7%), 1 satisfactory (2.7%), and 1 fair (2.7%). The disabilities of the arm, shoulder, and hand (DASH) questionnaire revealed good overall subjective evaluation with a mean of 7 points. The mean visual analog scale (VAS) pain score was 0.8. Patients with a CC distance <5 mm, or an anterosuperior AC reduction less than 50%, showed significantly better results in CS and DASH score in comparison to patients with a subluxated AC joint (P < .005). Twenty-two patients agreed to undergo isokinetic evaluation. We were unable to demonstrate any clinically significant difference between the involved and the uninvolved side.


CONCLUSIONS
The described technique of cerclage augmentation offers an attractive alternative in AC joint stabilization, with good to excellent results. In comparison to other techniques, there were no complications related to any implants, no graft donor site morbidity, or need for implant removal.
Lädermann
Alexandre
A
Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, Geneva, Switzerland. Alexandre.laedermann@hcuge.ch
Grosclaude
Maxime
M
Lübbeke
Anne
A
Christofilopoulos
Panayiotis
P
Stern
Richard
R
Rod
Thierry
T
Hoffmeyer
Pierre
P
D000173:Acromioclavicular Joint / Q000000981:diagnostic imaging / Q000293:injuries*; D002114:Calcinosis / Q000150:complications; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000601:surgery*; D008023:Ligaments, Articular / Q000601:surgery*; D019637:Orthopedic Procedures; D010147:Pain Measurement; D011859:Radiography; D020127:Recovery of Function; D012189:Retrospective Studies; D013536:Suture Techniques