[Treatment of acromioclavicular joint separations. Central Kirschner- wire and PDS-augmentation]

Beside the basic question wether a separation of the acromioclavicular joint should be treated operatively or not, the method of operation is discussed in particular. For that reason we investigated our own method of a temporary transfixation of the joint by a centrally drilled K-wire combined with a PDS-augmentation of the coracoclavicular and a suture of the acromioclavicular ligament. Follow up examinations were possible in 57 out of 82 patients which were operated during 5 years. Patients subjective rating and objective follow up and sonographically evaluated joint conditions were scored together. Looking for the range of motion of the shoulder only 5.5% of the patients had a reduction of more than 20 degrees. Out of 12 complications in particular three infections only resulted satisfying by influencing the subjective rating negatively. In 28.1% of patients no durable anatomic reconstruction of the joint was achieved. Score achieved by these patients was significantly lower compared to those with a lasting anatomic reconstruction of the acromioclavicular joint. In conclusion the results confirm our operative regime for separations of the acromioclavicular joint. In literature survey the here described method of operation belongs to the better ones without showing a clear advantage. Nevertheless the method should be modified to decrease the rate of subluxations.