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

PURPOSE: 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.

MATERIAL AND METHODS: 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).

RESULTS: 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.

CONCLUSION: 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.