Purpose
To introduce an arthroscopically assisted coracoclavicular (CC) fixation technique
using multiple low-profile devices to evaluate the clinical and radiologic outcomes
in patients with acute high-grade acromioclavicular (AC) joint dislocation.
Methods
Between July 2014 and September 2015, cases of AC joint dislocation that were treated
with arthroscopic CC fixation using multiple low-profile devices with a minimum follow-up
of 24 months were included. We measured the vertical coracoclavicular distance (CCD)
on the anteroposterior view and the horizontal acromioclavicular distance on 3-dimensional
computed tomography images to evaluate the changes in radiologic outcomes before and
after surgery. We compared final radiologic outcomes between initial AC reduction
groups based on hierarchical clustering. Clinical outcomes were evaluated using the
Constant-Murley score.
Results
We enrolled 27 patients in total, and the mean follow-up period was 27.2 months. The
mean CCD of the injured shoulder was 13.68 ± 3.98 mm preoperatively and decreased
to 5.72 ± 1.68 mm immediately postoperatively but increased to 7.32 ± 2.29 mm at last
follow-up (P = .07). Horizontal displacement of the distal clavicle was 1.1 ± 1.0 mm immediately
postoperatively but decreased to 0.9 ± 0.6 mm at last follow-up (P < .05). In particular, in the 2 groups that were determined using the hierarchical
cluster analysis, patients with excellent recovery of the initial CCD (20 patients)
showed less of an increase in the CCD at last follow-up than did those in the other
group (7 patients) (P < .001). The Constant-Murley score was 93.5 ± 2.7 points on the injured side at last
follow-up (P = .074).
Conclusions
Our CC fixation technique with multiple low-profile devices exhibited satisfactory
clinical and radiologic outcomes. In particular, ensuring good initial recovery of
the CCD and the precise placement and location of the AC joints was important in maintaining
the proper AC position at the final follow-up.
Level of Evidence
Level IV, case series.
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Article info
Publication history
Published online: November 16, 2018
Accepted:
July 5,
2018
Received:
August 20,
2017
Footnotes
The authors report the following potential conflicts of interest or sources of funding: This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF), funded by the Ministry of Education (NRF-2016R1D1A1A09920056). Full ICMJE author disclosure forms are available for this article online, as supplementary material.
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© 2018 by the Arthroscopy Association of North America
