[Repair of acromioclavicular dislocation with clavicular hook plate internal fixation and coracoacromial ligament transposition]

Xiaodong Li, Liangen Yang, Hongliang Lou, Chunyu Wang, Jiwei Wu, Zhao Li, Yi Yao
Chinese Journal of Reparative and Reconstructive Surgery 2009, 23 (6): 654-6

OBJECTIVE: To explore the operative method and the clinical outcomes of repairing acromioclavicular dislocation by clavicular hook plate internal fixation and coracoacromial ligament transposition.

METHODS: From August 2004 to December 2007, 12 cases of acromioclavicular dislocation were repaired with the internal fixation of clavicular hook plate and the transposition of coracoacromial ligament. There were 9 males and 3 females aged 22-56 years old (average 32 years old). Causes of injury: 6 cases from falling injury, 4 cases from crush injury and 2 cases from traffic accident. There were 5 cases of the left acromioclavicular dislocation, and 7 cases of the right. According to acromioclavicular dislocation classification set by WANG Yicong, 8 cases were graded as type III, 3 cases as type IV, and 1 case as type V. The time from injury to operation was 3-28 days (average 6 days). The injured arm was hung after operation, and the function training was started 3-5 days after operation.

RESULTS: All wounds healed by first intention, and the X-ray films showed complete reposition of acromioclavicular joints was achieved in all cases 1 week after operation. Over the follow-up period of 12-30 months, no plate and screw loosening, hook break and acromion fracture occurred. At 2 months after operation, 2 patients had slight pain when moving the shoulder, and the symptom disappeared when removing the plate. No re-dislocation was observed in all cases after removing the plate at 6-10 months after operation. The function of shoulder joint was assessed by Karlsson evaluation standard 1 year after operation, 11 cases were graded as excellent and 1 case was good.

CONCLUSION: For the repair of acromioclavicular dislocation, the method of combining clavicular hook plate internal fixation with coracoacromial ligament transposition has the advantages of minor wound, easy operation, little influence on the function of shoulder joints, and reliable restoration of the stability of shoulder joint.

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