title: Radiographic changes in the operative treatment of acute acromioclavicular joint dislocation - tight rope technique vs. K-wire fixation.
abstract: BACKGROUND
  Operative treatment of higher degree acromioclavicular joint luxation is common. A new option is made available by the tight rope technique. It claims to provide adequate outcome with the use of a minimally invasive technique. First clinical studies justified its medical use, but the equivalence to established surgical methods remains unclear. We therefore analyzed radiographic data from patients that were treated with the tight rope system (TR) and compared them to those treated with K-wires (KW) fixation.
  
  
  METHODS
  RETROSPECTIVE STUDY WITH INCLUSION CRITERIA: surgery for acromioclavicular joint luxation between 2004 and 2011, classified as Rockwood type III, no concomitant injury, first event injury. We compared pre- and post-operative X-rays with those taken at the end of treatment. Clinical data from follow-ups and radiographic data were evaluated. The main outcome variable was the remaining distance between the acromion and clavicle (ACD), as well as the coracoid process and clavicle (CCD).
  
  
  RESULTS
  27 patients (TR: n=16; KW: n=11) with comparable demographics and injury severity were included. Surgery reduced ACD (TR: p=0.002; KW: p<0.001) and CCD (TR: p=0.001; KW: p=0.003). Heterotopic ossification or postoperative osteolysis was not significantly associated with either one of the procedures. Three patients (18.75%) in the TR group showed impaired wound healing, migrating K-wires were recorded in 2 patients (18.2%) and impingement syndrome occurred in 1 patient (9.1%) with K-wires. Posttraumatic arthritis was not seen. There was a loss of reduction in 2 cases within the TR-group (12.51%) and 1 in the KW-group (9.1%). At last follow up, ACD and CCD were wider in both groups compared to the healthy side.
  
  
  CONCLUSIONS
  This study shows that the Tight rope system is an effective alternative in the treatment of higher degree acromioclavicular luxation and comparable to the established methods.
authors: Department of Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Aachen, Germany.
authors: Klemens
authors: K
authors: Horst
authors: Department of Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Aachen, Germany.
authors: Thomas
authors: T
authors: Dienstknecht
authors: Department of Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Aachen, Germany.
authors: Hagen
authors: H
authors: Andruszkow
authors: Department of Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Aachen, Germany.
authors: Gertraud
authors: G
authors: Gradl
authors: Department of Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Aachen, Germany.
authors: Philipp
authors: P
authors: Kobbe
authors: Department of Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Aachen, Germany.
authors: Hans-Christoph
authors: HC
authors: Pape
keywords: K-wire; radiographic changes; tight rope