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Complete acromioclavicular separations. A comparison of operative methods.
Clinical Orthopaedics and Related Research
|March 1, 1987
Summary
Surgical treatment for complete acromioclavicular (AC) dislocations shows AC fixation methods are more successful than coracoclavicular (CC) fixation. AC fixation offers excellent results with fewer recurrences, though minor complications exist.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Traumatology
Background:
- Complete acromioclavicular (AC) dislocations are injuries requiring surgical intervention.
- Various surgical techniques exist for treating AC dislocations, including AC and coracoclavicular (CC) fixation methods.
Purpose of the Study:
- To compare the efficacy of different surgical treatment methods for complete AC dislocations.
- To evaluate outcomes based on pain, range of motion, and deformity.
Main Methods:
- Retrospective review of 90 cases from 95 surgical procedures performed between 1972-1985.
- Comparison of AC fixation (Kirschner wires alone, with ligament transfer, or tension wiring) versus CC fixation.
- Excision of the distal clavicle for chronic dislocations.
Main Results:
- AC fixation methods demonstrated higher success rates compared to CC fixation.
- Over 89% excellent results were achieved with both AC and CC methods.
- AC fixation had more minor complications (infections, implant breakage) but no recurrences, while CC methods had a 9% failure/recurrence rate.
Conclusions:
- AC fixation techniques are generally more successful for complete AC dislocations than CC fixation.
- Kirschner wire with tension wiring yielded the best AC fixation results, despite complex implant removal.
- Distal clavicle excision is a viable option for chronic, painful AC dislocations.