title: K-wire Arthrodesis and Coracoclavicular Augmentation of Complete Acromioclavicular Separations: Functional and Subjective Results.
abstract: BACKGROUND
  In recent years, there has been a trend from operative to conservative management of complete acromioclavicular separations. Despite this, surgical treatment is still recommended to manual workers and athletes, who account for a large part of the patients. The objective of this study was to evaluate the functional outcome of type III separations according to Tossy managed by temporary arthrodesis of the acromioclavicular joint combined with coracoclavicular augmentation. Special attention was paid to sport exercising patients.
  
  
  METHODS
  In this study, 32 patients (mean age 39 years) with a complete acromioclavicular separation were investigated. All of them underwent a surgical treatment managed by temporary acromioclavicular arthrodesis with two parallel k-wires and augmentation of the coracoclavicular ligaments with a biodegradable cord (PDS). Functional outcome was assessed after an average follow-up of 36 months by using the Constant-Murley-, Neer- and DASH-score. Additionally, incidence of complications and subjective results were observed.
  
  
  RESULTS
  Evaluation of the data, obtained from the scores, revealed an excellent result for the Constant-Murley- and DASH-score for 84% of the patients. Regarding the Neer-score, 78% had an excellent outcome. Eighty-four percent of the patients assessed revealed an excellent to fair subjective result. Cosmetic reasons were most frequently the cause for discontentedness. Minor complications occurred in three patients without severe sequelae. All patients returned back to former working and sport activity level.
  
  
  CONCLUSIONS
  Surgical treatment of complete acromioclavicular separations by temporary arthrodesis with two k-wires and coracoclavicualar PDS-augmentation results in good to excellent function. It is associated with a low complication rate and a high patient contentedness. Particularly for athletes in non-contact sports this surgical technique can still be recommended.
authors.affiliation: Department of Trauma and Hand Surgery, University Hospital Düsseldorf, Düsseldorf, Germany. Tim.Loegters@uni-duesseldorf.de.|Department of Trauma and Hand Surgery, University Hospital Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany. Tim.Loegters@uni-duesseldorf.de.
authors.forename: Tim T
authors.initials: TT
authors.lastname: Lögters
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Briem
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Lohde
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Arne
authors.initials: A
authors.lastname: Janssen
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Johannes M
authors.initials: JM
authors.lastname: Rueger
authors.affiliation: Department of Trauma and Hand Surgery, University Hospital Düsseldorf, Düsseldorf, Germany.
authors.forename: Joachim
authors.initials: J
authors.lastname: Windolf
authors.affiliation: Department of Trauma and Hand Surgery, University Hospital Düsseldorf, Düsseldorf, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Linhart
keywords: Acromioclavicular arthrodesis; Acromioclavicular joint; Coracoclavicular augmentation; Operative treatment; Sport injury