[Comparative study of surgically treated shoulder injuries with or without metal implants]

In 36 patients with acromioclavicular fracture type III, IV and V following the Rockwood classification, different surgical procedures without using metal implants were compared. Augmentation of both, the coracoclavicular and acromioclavicular ligaments was done by Vicryl-threads (5 mm) in 26 cases (group I). Solitary augmentation of coracoclavicular ligaments were done in 6 cases (group II), of acromioclavicular ligaments in 4 cases (group III). Twenty-four patients underwent follow-up regarding clinical, ultrasonic and radiological results after 30 month in average. Dislocations of more than 10 mm we found once in group I and II, three times in group III. Using the Taft score, regarding clinical, ultrasonic and radiological findings, five patients had an excellent, 15 a good five patients a satisfying result and the remaining patient had a poor reconstruction of the acromioclavicular joint. Comparing these results with previous 75 patients who underwent surgical reconstruction of acromioclavicular joint, using metal implants between 1980 and 1985, the results were nearly equal. Although severe complications like migration or fracture of the implant and the necessity for another surgical intervention for explantation were not given in patients who were treated without using metal implants. Solitary augmentation of acromioclavicular ligament showed insufficient results, therefore this therapy should not be recommended anymore.