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Functional and Radiological Outcomes of the Surgical Treatment of Acute Acromioclavicular Dislocation with Anchors Associated with Clavicle and Scapula Fixation

Objective  To evaluate the clinical, radiological and functional results of the surgical treatment of acute acromioclavicular dislocation using a coracoclavicular fixation technique (syndesmopexy) with two metallic anchors, temporary clavicle and scapula fixation, and transfer of the coracoacromial...

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Detalles Bibliográficos
Autores principales: Mendes Júnior, Adriano Fernando, Mota Neto, José da, Dias, Darlan Malba, Simoni, Leandro Furtado de, Loures, Elmano de Araújo, Labronici, Pedro José
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Brasileira de Ortopedia e Traumatologia. Published by Thieme Revnter Publicações Ltda 2019
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6923650/
https://www.ncbi.nlm.nih.gov/pubmed/31875063
http://dx.doi.org/10.1055/s-0039-1697020
Descripción
Sumario:Objective  To evaluate the clinical, radiological and functional results of the surgical treatment of acute acromioclavicular dislocation using a coracoclavicular fixation technique (syndesmopexy) with two metallic anchors, temporary clavicle and scapula fixation, and transfer of the coracoacromial ligament. Methods  Longitudinal observational study of 30 patients with diagnoses of acute acromioclavicular dislocation, who were submitted to surgical treatment with a minimum follow-up of six months, and who were evaluated clinically, radiologically, and by the University of California at Los Angeles (UCLA), the Disabilities of the Arm, Shoulder and Hand (DASH) and the Constant-Murley functional scores. Results  The mean values of the scores were: UCLA = 32; DASH = 11.21; and Constant-Murley = 86.93, with satisfactory results higher than 80%. The unsatisfactory results were associated with acromioclavicular pain on palpation, positive subacromial impingement tests, and older age group, presenting statistical significance ( p  < 0.05). Radiologically, higher values on account of the coracoclavicular distance ratio from the operated shoulder compared to the normal shoulder were related to worse outcomes, but with no statistically significant difference. No associations were found between the results of the functional scores and the variables degree of the injury, coracoacromial ligament transfer, clinical impression of loss of reduction and scapulothoracic dyskinesis. Conclusion  The technique used provides an efficient fixation, with a high level of satisfaction according to the UCLA, Constant-Murley and DASH scores; moreover, it has a low complication rate, despite the high rate of residual radiological acromioclavicular subluxation.