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A comparative analysis of the efficacy of modified double-bundle suspension fixation versus single-bundle suspension
Dan Wen1, Pei Zhang1, Yaojia Lu1
1Department of Orthopedics, Northern Jiangsu People's Hospital, Affiliated to Yangzhou University, Yangzhou, 225001, P. R. China.
Objective:
This study aimed to compare clinical and radiologic outcomes between modified double-bundle suspension fixation and single-bundle suspension fixation for the treatment of acute acromioclavicular joint (ACJ) dislocation.
Method:
A retrospective analysis was performed on the clinical data of 68 patients with ACJ dislocation treated in the orthopedics department of our hospital between May 2020 and May 2024. Patients were categorized into two groups according to their surgical techniques: 30 patients received the modified double-bundle suspension fixation technique (MDB group), while 38 patients underwent the traditional single-bundle suspension fixation technique (SB group). The study statistically analyzed and compared clinical baseline characteristics, surgical parameters, Visual Analogue Scale (VAS); scores, Constant-Murley Shoulder Function Score (Constant-Murley score). On the plain radiograph, the coracoclavicular (CC) interval ratio (CCIR)was measured to evaluate maintenance of CC interval fixation. Postoperative complications, including reduction failure, titanium plate slippage, or bone resorption around the titanium plate, were also documented.
Result:
No statistically significant differences were observed in preoperative data between the two groups (P > 0.05). The MDB group showed longer average surgical duration compared to the SB group (P < 0.05), while no significant differences were found in incision length, intraoperative blood loss, or postoperative hospitalization duration (P > 0.05). Postoperatively, at day 2, 3 months, 6 months, and the final follow-up, the MDB group demonstrated significantly better VAS scores, Constant-Murley scores, and CCIR measurements than the SB group (P < 0.05). During the follow-up period, no complications were observed in the MDB group, whereas the SB group experienced 8 cases (8/38) of complications, including 6 cases of lost reduction, 1 case of titanium plate displacement, and 1 case of bone dissolution. According to the classification, one case was classified as type Ⅲ, while the remaining cases were classified as type IV/V.
Conclusion:
Compared with single-bundle fixation, the modified double-bundle fixation technique for ACJ dislocation demonstrates significant advantages in preventing postoperative loss of reduction, particularly in cases of high-grade ACJ. Additionally, it is associated with reduced postoperative pain and superior recovery of shoulder joint function. Moreover, compared with existing double- bundle fixation techniques, this surgical approach exhibits a diminished suture-bone abrasion between the suture and bone tunnel, which is worth further study.
