Double Fixation for Acute Acromioclavicular Dislocation: Recovery of Horizontal Stability as a Key Factor for Anatomical Reduction

Abstract

Introduction: Different publications have concluded that coracoclavicular and acromioclavicular ligament complex reconstructions with re-establishment of clavicular horizontal stability are key elements in avoiding residual instability of the acromioclavicular joint.
Methods: A total of 14 patients diagnosed with acute types III, IV and V acromioclavicular dislocations were evaluated after a double fixation technique using coracoclavicular suture anchors and a hook plate with the use of an acromioclavicular reductor to obtain anatomical reduction of the dislocated acromioclavicular joint between February 2011 and February 2012. The Constant-Murley score and simple X-ray evaluations were performed at 4, 8 and 12 weeks after surgical treatment. All hook plates were removed 12 weeks after surgery, and three weeks after this procedure, coracoclavicular and acromioclavicular healing was evaluated by using magnetic resonance imaging to finally complete a 6 month follow-up for each patient.
Results: The 14 patients, with a mean age of 26 years, included in the study had an overall follow-up of 6 months. The mean Constant-Murley score was 97 points at twelve weeks follow-up. No complications were observed, and all the patients had mild sub-acromial impingement symptoms that subsided once the hook plate was removed at 12 weeks follow-up.
Discussion: The results support that the acromioclavicular reduction tool helps to obtain anatomical reduction of the joint during the coracoclavicular reconstruction, while the hook plate holds this joint reduction in place, and allows an early start of physiotherapy, with no associated complications.