Comparison Between Two Surgical Techniques Acromioclavicular Tension Band Wiring and Coracoclavicular Screw in Acromioclavicular Dislocations

Authors

1 Orthopedic Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran

2 Orthopedic Research Center, Shahid Kamyab Hospital, Mashhad University of Medical Sciences, Mashhad, IR Iran

3 Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, IR Iran

10.5812/rijm.20336

Abstract

Background: Acromioclavicular (AC) joint dislocations are common in young, active patients and frequently treated in clinical practice. There are many surgical treatments for acro-mioclavicular joint dislocation. The goal of this study was comparing the functional and clinical post-operative results between two urgical techniques, acromioclavicular tension band wiring and coracoclavicular screw in acromioclavicular dislocations. Patients and Methods: 20 patients with Rockwood dislocation type III and more referred to Kamyab Hospital from February 2012 to November 2013. They were assessed in terms of surgical indications. The patients were divided in to two groups and the authors used tension band wiring and screw fixation procedures for each group. Coracoclavicular ligaments were repaired in both techniques. In 1, 6 and 12- month follow-up periods, we assessed clinically the acromiomclavicular stability, articular range of motion, VAST score and Oxford shoulder score with stress radiography. The results were then analyzed statistically. Results: Mean age of the patients was 34 ± 8.1 years and 80% were male. Totally, 17 patients (85%) were type 3 Rockwood and 3 patients (15%) were type 5. Full stability was obtained in all patients by comparing the stress radiography and the post-operative ones. About 50% of patients had Oxford shoulder score (OSS) 42-48. 13 patients (65%) did not complain of any pain and 25% had moderate VAST score (4-7). 17 patients (85%) had range of motion more than 150-180. Using t-Student test, no significant difference in type of Rockwood, articular stability, range of motion, OSS score and VAST SCORE was seen between the two groups (P > 0.05). Conclusions: Bosworth screw and Tension band wiring are both useful procedures in patients with ACJ dislocation, but each should be used in the selected patients with special indications. Both methods had good results during follow-up period. There was not statistically meaningful difference in the articular stability, range of motion, OSS score and VAST SCORE between the two groups (P > 0.05).

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