Acute acromioclavicular dislocation: hook plate vs. coracoclavicular sutures
Keywords:
Acromioclavicular Joint, Shoulder Dislocation, Orthopedic Fixation Devices, Reconstructive Surgical Procedures, Suture TechniquesAbstract
Introduction: There is actually no consensus on the ideal surgical treatment of acute acromioclavicular dislocations. The use of the hook plate and suture anchors are both therapeutic options in the aim of achieving acromioclavicular joint reduction and healing. That is why this study wants to approach which technique is better on regards the recurrence and function.
Methods: A clinical trial was performed including 36 patients diagnosed with acute acromioclavicular dislocations grades III to V according to the Rockwood classification between September 2008 and February 2011 in Hospital Pablo Tobón Uribe, Medellín, Colombia. Patients were randomized in two surgical groups: one group treated with direct acromioclavicular reduction using a hook plate and another group with coracoclavicular suture anchors.
Results: 36 patients were included and randomized in two surgically treated groups for patients with acute acromioclavicular dislocation. A total of 19 (52.8 %) patients were treated with coracoclavicular reconstruction using suture anchors and the second group of 17 (47.2%) patients were treated with direct acromioclavicular reduction using a hook plate. Grade IV dislocation according to the Rockwood classification was the most frequently diagnosed (47.2%) followed by grade III (41.7%). We were forced to suspend patient recruitment due to the recurrence rate (52.6% for the suture anchor group and 23.5% for the hook plate group). Constant score was similar for both groups independent of recurrence.
Discussion: Based on data obtained it can be concluded that the coracoclavicular suture anchor technique has a higher recurrence rate than the direct acromioclavicular reduction technique using a hook plate. Another study should be completed in order to identify an explanation for the high recurrence rate with the coracoclavicular suture anchor technique.
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