K-wire Arthrodesis and Coracoclavicular Augmentation of Complete Acromioclavicular Separations: Functional and Subjective Results |
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| Authors: | Tim T Lögters Daniel Briem Christian Lohde Arne Janssen Johannes M Rueger Joachim Windolf Wolfgang Linhart |
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| Institution: | (1) Department of Trauma and Hand Surgery, University Hospital Düsseldorf, Düsseldorf, Germany;(2) Department of Trauma, Hand and Reconstructive Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany;(3) Department of Trauma and Hand Surgery, University Hospital Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany |
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| Abstract: | 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.
Patients and 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.
Conclusion: 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.
Tim T. L?gters, Daniel Briem are contributed equally and therefore share first authorship |
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| Keywords: | Acromioclavicular joint Operative treatment Coracoclavicular augmentation Acromioclavicular arthrodesis Sport injury |
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