Analysis of risk factors for loss of reduction after acromioclavicular joint dislocation treated with the suture-button |
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| Institution: | 1. Department of Orthopaedic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China;2. Department of Orthopaedic Surgery, The Second Affiliated Hospital and Yuying Children''s Hospital of Wenzhou Medical University, Zhejiang Provincial Key Laboratory of Orthopaedics, Wenzhou, Zhejiang, China;1. Department of Orthopedic Surgery, Okayama University Hospital, 2-5-1, Shikata-cho, Okayama City, 700-8558, Okayama, Japan;2. Department of Orthopedic Surgery, Shikoku Cancer Center, Japan;3. Department of Radiology, Shikoku Cancer Center, Japan;4. Clinical Research Center, Shikoku Cancer Center, Japan;5. Department of Orthopedic Surgery, Okayama University Hospital, Japan;1. Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan;2. Second Division of Physical Therapy, Sapporo Medical University School of Health Sciences, Sapporo, Hokkaido, Japan |
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| Abstract: | BackgroundThe most commonly reported complication after acromioclavicular (AC) joint dislocation treated with the Suture-button is loss of reduction. Loss of reduction is a major factor influencing the patient's joint function and subjective satisfaction. The objective of this study is to analyze the risk factors causing loss of reduction after AC joint dislocation treated with the Suture-button.MethodsOne hundred and thirty patients with AC joint dislocation who were surgically treated the Suture-button in our hospital from February 2009 to February 2015, were recorded their age, sex, BMI, time from injury to surgery, Rockwood's classification, with or without osteoporosis, double or triple button technique, position of the clavicle tunnel, tunnel diameter, coracoid button position, alignment of the button, acromioclavicular ligament repair or not, different methods of postoperative limb immobilization, and so on. Mean comparisons or chi-square test was used for univariate analysis of the above factors, and then multivariate logistic regression analysis was performed to predict risk factors.ResultsReduction was lost in 23.1% of the patients. Univariate analysis showed that button alignment, double or triple button technique, coracoid button position, position of the clavicle tunnel, acromioclavicular ligament repair or not and osteoporosis had statistically significant association with loss of reduction for AC joint (P = 0.031, 0.034, 0.000, 0.042, 0.047 and 0.000 respectively). Multivariate logistic regression analysis demonstrated that osteoporosis (P = 0.003), position of the clavicle tunnel (P = 0.032) and coracoid button position (P < 0.001) were the risk factors that significantly associated with the loss of reduction after AC joint dislocation treated with the Suture-button.ConclusionsClavicle tunnel location using relative ratio method, accurate placement of button plate under coracoid process (inside or outside deviation <20°), various reinforcement operations for patients with osteoporosis are important factors in preventing loss of reduction. |
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