Review of the results of different operative procedures for old acromioclavicular dislocation / 中华骨科杂志

ABSTRACT

Objective To compare the results of different operative methods for old acromioclavicular dislocation. Methods Forty three patients with old acromioclavicular dislocation were treated with three different operative methods: 1)open reduction plus Kirschner wire fixation (9 cases); 2)open reduction plus reconstruction of acromioclavicular ligament (14 cases) and 3)open reduction plus modified Dewar s operation (20 cases). After surgery, the subjective symptoms of the arm, muscular contraction power, function of the shoulder joint and space of acromioclavicular joint in 43 cases were followed up for an average 4.8 years. Results The excellent results following three operative methods were seen in 33％ , 50％ and 74％ respectively. There was no significant difference between Kirschner wire fixation and reconstruction of acromioclavicular ligament (P > 0.05). Modified Dewar's operation was better compared with Kirschner wire fixation and reconstruction of acromioclavicular ligament (P< 0.05). Conclusion A satisfactory surgical procedure for treatment of old acromioclavicular dislocation should accomplish the following points removal of scar tissue and intra articular cartilaginous fragments, reconstruction of joint stability and effective internal fixation until complete healing of the ligament structures.