[Treatment of fresh Tossy III acromioclavicular joint dislocation by ligament suture and temporary fixation with the...

Retrospective analysis of the functional and radiographic outcome of a new temporary fixation device in the surgical treatment of acromioclavicular joint dislocation stage Tossy III.

Between 1986 and 1993, 19 patients with acute acromioclavicular (AC) dislocation (stage Tossy III) were treated with the clavicle hook-plate as a temporary fixation device combined with suture of the ligaments. Active shoulder mobilization started three days postoperatively. The mean follow-up was 3.9 years (range, 2 to 9.5 years).

The mean Constant Score was 94 points (range, 83 to 100 points). All of the patients were able to resume their occupational activities and seventeen (89.5%) could completely resume their prior program of physical fitness. Radiological signs of an AC arthritis were found in 21% of the cases, but only 1 patient had a painful AC-joint. The average distance between the superior aspect of the coracoid process and the inferior aspect of the clavicle in the stress x-ray (5 kp each side) of both AC-joints was preoperatively 20.7 mm (range, 12-50 mm) comparing to 9.5 mm (range, 6-15 mm) for the operated shoulder and to 9 mm (range, 4 to 12 mm) for the nonoperated side in the follow-up. No reluxation was found. Two superficial wound infections (10.5%) were treated successfully with antibiotics without removal of the implant. Neither breakage nor loosening of the clavicle hook-plate were observed.

Our mid- and longterm results confirm the value of the clavicle hook-plate as an alternative to other temporary fixation devices in the surgical treatment of acromioclavicular dislocation stage Tossy III.