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Chronic acromioclavicular dislocations: multidirectional stabilization without grafting.

José Antonio Cano-Martínez1, Gregorio Nicolás-Serrano1, Julio Bento-Gerard1

  • 1Department of Orthopaedic Surgery, University of Murcia, Los Arcos del Mar Menor General Hospital, Murcia, Spain.

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|September 17, 2020
PubMed
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The triple button device offers a simple, effective surgical solution for chronic acromioclavicular joint dislocations. This method shows excellent clinical outcomes and radiological improvements without major complications.

Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Traumatology

Background:

  • Chronic acromioclavicular (AC) joint dislocations present a significant challenge in orthopedic practice.
  • Surgical management aims to restore stability and function, but various techniques have associated drawbacks.

Purpose of the Study:

  • To evaluate the clinical and radiological outcomes of surgical treatment for chronic AC dislocations using a triple button device.
  • To assess the efficacy of AC joint augmentation with this specific surgical technique.

Main Methods:

  • Retrospective analysis of 21 patients with chronic AC dislocations.
  • Utilized bilateral-weighted Zanca and Alexander views for radiographic assessment.
  • Clinical evaluation included the Constant score (CS) and Acromioclavicular Joint Instability Scoring System (ACJI).
Keywords:
Acromioclavicular jointTwin Tail TightRope techniqueanatomic reconstructionchronic dislocationhorizontal stabilityminimally invasive surgery

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Main Results:

  • Mean follow-up of 49.7 months showed high CS (95.2) and ACJI (89.7) scores, comparable to the uninjured shoulder.
  • Significant radiological improvement in coracoclavicular distance (12.8 mm to 8.5 mm) and AC distance (7.8 mm to 0.99 mm).
  • No significant difference in outcomes compared to the contralateral healthy shoulder; osteoarthritis did not correlate with poorer results.

Conclusions:

  • The triple button device is a viable and acceptable surgical option for chronic AC joint dislocations.
  • The technique is straightforward, avoids the need for grafts, and does not require hardware removal.
  • This method presents a low complication rate and effective restoration of joint stability and function.