Journal of Musculoskeletal Trauma

A Comparison of Results between AO Hook Plate and TightRope for Acute Acromioclavicular Joint Dislocation: Yong Gun Kim, Ho Jae Lee, Dong Won Kim, Jinmyoung Dan; J Korean Fract Soc 2017;30(1):16-23. Published online January 31, 2017; DOI: https://doi.org/10.12671/jkfs.2017.30.1.16

PURPOSE
The purpose of our study is to compare the radiographic and clinical outcomes with respect to acromioclavicular (AC) joint dislocation depending on the surgical method: Hook plate (HP) versus TightRope (TR).
MATERIALS AND METHODS
Between May 2009 and May 2012, 51 patients with Rockwood type III-V lesions received clinical and radiographic follow-up. Patients were divided into two groups according to the surgical methods (HP: n=32; TR: n=19). Radiological follow-up included comparative coracoclavicular distance (CCD) measurements as a percentage of the uninjured shoulder. For clinical follow-up, a standardized functional shoulder assessment with the Constant score, University of California at Los Angeles (UCLA) score, and Korea shoulder score (KSS) were carried out.
RESULTS
Comparing the functional results, no differences were observed between the two groups (Constant score: HP, 78.5; TP, 81.4; UCLA score: HP, 29.2; TP, 29.9; KSS: HP, 79.2; TP, 80.7). Time to restoration of the range of motion (ROM) above shoulder level was longer in the HP group than in the TR group. However, the ROM at 1 year postoperation and final follow-up revealed similar results between the two groups. The AC joints were well reduced in both groups, the CCD increased to 44.7% in the HP group and to 76.5% in the TR group at the final follow-up; however, no one was significantly superior to the others. Furthermore, there were 8 cases (25.0%) and 5 cases (26.3%) of AC joint arthritis in the HP group and TR group, respectively. However, the observed AC joint arthritis has a poor correlation between clinical symptom and radiological results in both groups.
CONCLUSION
Both HP and TR fixation could be a recommendable treatment option in acute unstable AC joint dislocation. Both groups showed excellent radiologic and functional results at the final visit. Moreover, there was no significant difference in statistics, except for the time to restoration of ROM above shoulder level.

Citations

Citations to this article as recorded by

Arthroscopic Treatment of Acromioclavicular Joint Dislocations
Du-Han Kim, Chul-Hyun Cho
Journal of the Korean Orthopaedic Association.2023; 58(5): 384. CrossRef
Combination of Clavicular Hook Plate with Coracoacromial Ligament Transposition in Treatment of Acromioclavicular Joint Dislocation
Aikebaier Tuxun, Ajimu Keremu, Pazila Aila, Maimaitiaili Abulikemu, Zengru Xie, Palati Ababokeli
Orthopaedic Surgery.2022; 14(3): 613. CrossRef

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The Treatment of Acromioclavicular Dislocation Comparison Study between Bosworth Screw and Wolter Plate Technique: Jae Do Kang, Kwang Yul Kim, Hyung Chun Kim, Kyung Chil Jung, Mun Sup Lim, Jin Hyung Kim, Seong Joo Lee; J Korean Soc Fract 2003;16(4):548-554. Published online October 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.4.548

Abstract PDF: PURPOSE
Acromioclavicular joint dislocation are frequently seen and various operation treatment modalities have been suggested. The purpose of this study is to compare the clinical results of two operative methods, Bosworth screw procedure and Wolter plate technique.
MATERIALS AND METHODS
We have analysed 30 patients with acromioclavicular dislocations, which had been treated by Bosworth screw & Wolter plate technique from June 1996 to February, 2002 with minimal 1 year follow up. All patients were assessed clinical and radiological results by ASES Score and UCLA Score.
RESULTS
Using the Shoulder evaluation scheme of ASES and UCLA Score at the one year follow up examination, 93.4% of the patients had excellent results in Wolter plate group. In Bosworth screw group, 4 complications such as loosening of the screw, or breakage of screw were seen. 2 complicated patients were over 40 years old and then conversions to Wolter plate operation was needed and obtained good results.
CONCLUSION
Bosworth procedure has a merit not to damage acromioclavicular joint, but the technique is difficult, sometimes may be encountered loss of fixation due to overcorrection and anterior displacement of the clavicle. However, Wolter plate implant provides enough stability for active postoperative physiotheraphy, and hence accelerates rehabilitation. Therefore, this technique is thought to be a good modality in the treatment of acute acromioclavicular seperation.

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Surigcal Treatment for Acute Acromioclayicular Joint Dislocation: Nam Yong Choi, In Ju Lee, Moon Ku Choi, Young Chae Lee, Han Jin Kim, Chong Ook Shin; J Korean Soc Fract 1995;8(1):188-192. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.188

Abstract PDF: Thirty-one patients who had a acromioclavicular joint dislocation that were treated by surgical operation, between January 1990 and December 1993 at St. Pauls & Holy Family hospital were analyzed. The results are as follows; 1. There were twenty-five males and six females. The mean age was 33 years, ranging from 17 to 52 years old. 2. Out of thirty-one cases, twenty-six had good to excellent functional results. 3. As regards complication, wire migration occurred in two cases, wire breakage in one case, screw loosening in one, and subluxation following wire or screw removal in four.

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Complication Folloing Operative Treatment in Complete Acromioclavicular Joint Dislocation: Sung Kwan Hwang, Jae In Ahn, Heui Jeon Park, Zi Hoan Cha; J Korean Soc Fract 1988;1(1):64-70. Published online November 30, 1988; DOI: https://doi.org/10.12671/jksf.1988.1.1.64

Abstract PDF: The conservative treatment such as plinting, bandaging and harnessing in the partial disrupton of the acromioclavicular joint(Grade II or less) has been successuful, but many surgeons prefer to operative treaments for complete A-C dislocation(Grade III). Though more than 55 operative methods of treatment were reported in the literature, they could be divided into four categories: 1) acromioclar reduction and acromioclavicular fixation, 2) acromicoclavicular reduction, coracoclavicular ligament repair, and coracoclavicular fixation, 3) distal clavicle excision, and 4) muscle transfers. Among numerous operative methods, we used Weaver-Dunn technic, A-O tension Band technic, and Modified bosworth technic in total 28 cases of complete A-C dislocation from March 1984 to June 1988 at the Yonsei University Wonju College of Medicine, Wonju Christian Hospital. In most cases, excellent or good results were obtained, but we stillfound swveral postperative complications. We experienced neither deep wound infection nor osteomyelitis. All 6 cases had fixation-related complications. After close examination of operation notes and X-rays, following suggestions were considered. 1. Reduce every A-C joint anatomically before inserting K-wires through A-C joints. 2. Start shoulder motion several days after operation to provide enough time form healing of deltoid and trapezius muscles. 3. Surgenous play a major role to prevent commplications such as malposition of fixatives and incomplete A-C joint reduction

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