Long Term Follow up Results of the Operative Treatment of the Acromioclavicular Joint Dislocation with a Wolter Plate

PURPOSE: To evaluate the long-term clinical and radiological results of the operative treatment of the acromioclavicular dislocation with a Wolter plate. MATERIALS AND METHODS: We reviewed clinical and radiological data of twenty patients (mean age: 37 years) who underwent the operative treatment of acromioclavicular joint dislocation using a Wolter plate from September, 1999 to December, 2002 with minimum of five years follow-up (average 6 years 7 months). The clinical outcomes of twenty patients were evaluated by UCLA scoring and radiological results of fifteen patients with available radiograph were evaluated by Zanca view and stress view. RESULTS: The mean UCLA score was mean 33 points (range, 27~35) at final follow up. By clinical evaluation, twelve cases (60%) were excellent, six cases (30%) were good and two cases were poor (10%). By radiological evaluation, eight cases (54%) were excellent (without displacement), five cases (33%) were good (displacement 5 mm). Erosive change in acromioclavicular joint was seen in poor case. CONCLUSION: Wolter plate fixation may be a useful modality for treating acromioclavicular joint dislocation. Great care should be taken to make the hook hole at the appropriate position during operation for long-term prognosis.

Treatment of Type 2 Distal Clavicle Fracture using Wolter Plate

PURPOSE: This study examined the clinical results of the treatment of type 2 distal clavicle fracture with using a Wolter plate. MATERIALS AND METHODS: Between 2004 and 2007, 16 patient treated for type 2 distal clavicle fracture using a Wolter plate were included in this study. Their average age was 32.6 years and the postoperative mean follow-up period was 22.9 months. The reduction and union were qualified according to the immediate post-operative and final radiographs. The functional outcome was evaluated by Kona's system and the Constant score RESULTS: By Kona's functional evaluation, there were 12 cases with excellent results, 3 cases with good results and 1 case of fair results and the average Constant score was 90. All 16 cases showed bony union. As complications, there was 1 case in which the protruded hook of the plate could be palpated at the skin, and 1 case showed an acromial fracture, but all the cases dispalyed successful bony union and there was no acromioclavicular joint arthritis, infection or any other complications. CONCLUSION: Wolter plate fixation for type 2 distal clavicle fracture is a reliable surgical method for satisfactory reduction and rigid fixation, a lower incidence of nonunion and excellent clinical result

Result of Wolter Plate Fixation for the Treatment of Dislocation of Acromioclavicular Joint and Clinical Importance of Coracoclavicular Ligament Repair

PURPOSE: To evaluate the clinical result of the Wolter plate fixation for the acromioclavicular joint dislocation and the necessity of coracoclavicular ligament repair with the operation. MATERIALS AND METHODS: Twenty three patients operated between January 2003 to September 2005 with over 6 months of follow-up period were studied. The Constant-Murley scoring system was administered on 6 months postoperatively and stress films were taken for the surveillance of acromioclavicular joint and coracoclavicular distance after plate removal. All patients were classified into two groups in that coracoclavicular ligament was repaired (10 cases) or not (13 cases) and the clinical indices described above were compared. RESULTS: With the Wolter plate fixation for the acromioclavicular joint dislocations, 20 cases of Constant-Murley scores were more than 'good' except complicated 3 cases. The scores of the repaired group were 7 cases of excellent, 2 cases of good and 1 case of moderate to poor, and that of not-repaired group were 6 cases, 5 cases and 2 cases respectively. With mean coracoclavicular interspace on x-ray at postoperative 6 months, repaired group showed residual 9% of displacement from initial 194% but not-repaired group showed 28% from initial 188%. There's no statistically significant difference in clinical scores between two group (p=0.072) and neither was residual coracoclavicular interspace displacement (p=0.067). CONCLUSION: Short term follow-up of Wolter plate fixation for the acromioclavicular dislocation showed acceptable clinical results and there was no statistically significant difference between two groups of repaired coracoclavicular ligaments and not repaired.

A comparative study on three devices in treatment of dislocation of acromioclavicular joint / 中华创伤骨科杂志

Objective To compare the results of 3 methods to treat complete dislocation of acromioclavicular joint. Methods Three different surgical techniques were employed: Dewars procedure (in Group A of 32 cases),tension band wiring (in Group A of 44 cases), and Wolter plate fixation (in Group A of 20 cases). There were 81 males and 15 females, or totally 85 cases of acute dislocation and 11 chronic dislocation. Results 96 cases were followed up with an average period of 50 months. Acording to karlssons standards, in group A, 26 patients were assessed as good, 5 as fair and 1 as poor. In group B, 20 patients were assessed as good, 13 as fair and 11 as poor. In group C, 15 patients were assessed as good, 4 as fair and 1 as poor. There were differences between A and B, C and B. But there werent statistic differences between A and C. Conclusion The Dawers procedure is believed to be a good, simple and safe method to treat acromioclavicular joint dislocation, with no need of a second operation to remove the implant and with less complications.

Operative Treatment of Complete Dislocation of the Acromioclaviclar Joint with a Wolter Plate / 대한정형외과학회잡지

PURPOSE: We studied to analyse the results of Wolter plate fixation for the treatment of complete acromioclavicular joint dislocation. MATERIALS AND METHODS: From September 1999 to August 2000, 20 patients with complete dislocation of the acromioclavicular joint were treated by Wolter plate fixation. The radiologic and clinical outcomes were evaluated by UCLA scoring. The mean duration of follow up was fifteen months. RESULTS: Functional outcomes at the last follow up were excellent in eleven (55%), good in seven (35%) and poor in two cases (10%). The mean preoperative coracoclavicular interval on the injured side was 200% versus the normal side, and after operation this was 15%. In one case of an elderly patient, the plate was removed at 6 weeks due to loss of fixation. CONCLUSION: The Wolter plate fixation for complete acromioclavicular joint dislocation was considered as one of the effective method. But careful attention should be taken to prevent possible acromial fracture in the elderly.

Surgical Treatment of the Acute Acromioclavicular Joint Dislocation Using a Wolter Plate / 대한정형외과학회잡지

PURPOSE: To introduce the surgical technique of acute acromioclavicular joint dislocation using a Wolter plate and to evaluate its efficacy after surgical treatment. MATERIALS AND METHODS: Twenty-six patients who underwent surgical treatment of the acute acromioclavicular joint dislocation using a Wolter plate and who were followed up minimally for one year were reviewed. We analyzed the clinical results of pain, function, range of motion and radiologic reduction state of the acromioclavicular joint. RESULTS: All cases showed satisfactory results. By clinical evaluation, twelve cases (46%) were excellent and fourteen cases (54%) were good. By radiologic evaluation, twenty cases (77%) were excellent and six cases (23%) were good. By postoperative X-ray, vertical displacement of the clavicle was restored in all cases. No complications such as infection, loosening of screws, plate failure or redislocation after removal of the plate occurred. CONCLUSION: Acromioclavicular joint reconstruction using a Wolter plate is believed to be a useful method, which minimizes injury of the joint articular surface and provides enough stability for postoperative rehabilitation.