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. 2023 Apr 17;31(spe1):e252916.
doi: 10.1590/1413-785220233101e252916. eCollection 2023.

SURGICAL TREATMENT OF ACROMIOCLAVICULAR DISLOCATION: HOOK PLATE VERSUS SUTURE BUTTON

Muhsin Dursun  1 , Guray Altun  2 , Murat Ozsahin  3
Affiliations

SURGICAL TREATMENT OF ACROMIOCLAVICULAR DISLOCATION: HOOK PLATE VERSUS SUTURE BUTTON

Muhsin Dursun et al. Acta Ortop Bras. .

Abstract
in English, Portuguese

Objectives: We aimed to compare the functional and radiographical outcomes of reconstruction of acute unstable acromioclavicular joint (ACJ) dislocation using Hook Plate (HP) versus Suture Endobutton (SE) fixation techniques.

Methods: Forty-six consecutive patients with grade III to V ACJ dislocation according to Rockwood classification who underwent either HP or SE fixation in the period between January 2017 and June 2020 were evaluated. The treatment modalities were divided into either HP or SE fixation. The radiological assessment included standard anterior-posterior (AP) views to evaluate coracoclavicular (CC) distances for vertical reduction.

Results: CC distances were grouped as preoperative (CC1), early postoperative (CC2), and late postoperative (CC3). The distance variance between CC2 and CC3 was referred as ΔCC (CC3 - CC2). A statistically significant difference was found in ΔCC between the two groups (p=0.008). ΔCC was significantly higher in the SE group compared to the HP group (p<0.05). The Constant and UCLA Scores of patients in the SE group were found to be significantly higher than in the HP group patients.

Conclusion: Clinical outcomes were more satisfactory in patients with acute unstable ACJ dislocation who underwent SE compared to HP procedures, at the end of the first year. Evidence Level IV; Case Series.

Objetivo: Nosso objetivo foi comparar os resultados funcionais e radiográficos da reconstrução da luxação instável aguda da articulação acromioclavicular (ACJ) utilizando técnicas de fixação com placa com gancho (HP) versus botão de sutura (SE).

Métodos: 46 pacientes com luxação da ACJ de grau III a V, de acordo com a classificação de Rockwood, que foram submetidos à fixação com HP ou SE no período de janeiro de 2017 a junho de 2020, foram avaliados. As modalidades de tratamento foram divididas em fixação HP ou SE. Na avaliação radiológica, foi utilizada a incidência antero-posterior (AP) para avaliação da redução vertical, por meio da medida da distância córaco-clavicular (CC).

Resultados: As distâncias CC foram agrupadas em pré-operatória (CC1), pós-operatória imediata (CC2) e pós-operatória tardia (CC3). A variação da distância entre (CC2) e (CC3) foi denominada ΔCC. Uma diferença estatisticamente significativa foi encontrada na ΔCC entre os dois grupos (p=0,008). O ΔCC foi significativamente maior no grupo SE em comparação com o grupo HP (p <0.05). As pontuações de Constant e UCLA dos pacientes do grupo SE foram significativamente mais elevadas do que as dos pacientes do grupo HP.

Conclusão: Os resultados clínicos foram mais satisfatórios com a técnica SE em comparação com a HP ao final do primeiro ano. Nível de Evidência IV; Série de casos.

Keywords: Acromioclavicular Joint; Clavicle; Joint Dislocations; Surgical Procedures.

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Conflict of interest statement

All authors declare no potential conflict of interest related to this article.

Figures

Figure 1
Figure 1. A) Preoperative left shoulder XR of 47 years old male patient with Type 3 acromioclavicular dislocation B) Early postoperative XR of patient who underwent suture endobutton (SE). An overcorrection of the coracoclavicular distance can be observed. C) Postoperative XR of the same patient at the end of a one-year follow up. Resolution of the overcorrection of coracoclavicular distance can be observed.
Figure 2
Figure 2. a) Preoperative right shoulder XR of 42 years old male patient with type 5 acromioclavicular dislocation b) Early postoperative XR of the patient who underwent hook plate (HP) c) Postoperative XR of the same patient after HP removal.
See this image and copyright information in PMC

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References

    1. Li X, Ma R, Bedi A, Dines DM, Altchek DW, Dines JS. Management of acromioclavicular joint injuries. JBJS. 2014;96(1):73–84. - PubMed
    1. Chen YT, Wu KT, Jhan SW, Hsu SL, Liu HC, Wang CJ, et al. Is coracoclavicular reconstruction necessary in hook plate fixation for acute unstable acromioclavicular dislocation? BMC Musculoskelet Disord. 2021;22(1):127–127. - PMC - PubMed
    1. Di Francesco A, Zoccali C, Colafarina O, Pizzoferrato R, Flamini S. The use of hook plate in type III and V Acromioclavicular Rockwood dislocations: Clinical and radiological midterm results and MRI evaluation in 42 patients. Injury. 2012;43(2):147–152. - PubMed
    1. Borbas P, Angelella D, Laux CJ, Bachmann E, Ernstbrunner L, Bouaicha S, et al. Acromioclavicular joint stabilization with a double cow-hitch technique compared to a double tight-rope: A biomechanical study. Arch Orthop Trauma Surg. 2022;142(7):1309–1315. - PubMed
    1. Tauber M. Management of acute acromioclavicular joint dislocations: current concepts. Arch Orthop Trauma Surg. 2013;133(7):985–995. - PubMed

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