Treatment of Tossy Ⅱ & Ⅲ dislocation of acromioclavicular joint using rivets with thread / 中华骨科杂志

ABSTRACT

Objective To study the treatment effect of rivet with thread,instead of clavicular hook plate,for Tossy Ⅱ & Ⅲ dislocation of acromioclavicular joint.Methods From January 2008 to February 2009,totally 31 patients with Tossy Ⅱ or Ⅲ dislocation of acromioclavicular joint were treated using rivets with thread,including 19 males and 12 females at the age of 33-49 years(mean,41 years).Among these patients,19 suffered fresh acromioclavicular joint dislocation,9 suffered old acromioclavicular joint dislocation,and 3 did a failed fixation by clavicular hook plate.None of them was combined fracture.Mitek 3.0 mm rivet with thread was embedded to coracoid,with nonabsorbable thread connected with the rivet passing through the clavicle for fixation,and meanwhile ligament coracoclaviculare was restored or acromiocoracoid ligament displaced.Among them,12 patients assisted Kieschner wire fixation.The treatment effect was evaluated using Japanese Orthopaedic Association(JOA)scoring system and acromioclavicular joint dislocation scoring system.Results All patients were followed up 11-23 months(mean,17 months).In the patients without Kieschner wire fixation,JOA shoulder score was 65-95,excellent for 8 cases,good for 9,fine for 1,poor for 1,excellent and good rate was 89.47%(17/19);In the patients with Kieschner wire assisted fixation,JOA shoulder score was 74-97,excellent for 5,good for 4,fine for 3; the excellent and good rate was 75.00%(9/12).With acromioclavicular joint dislocation scoring system,the overall excellent and good rate was 94.74%(18/19),and 91.67%(11/12)respectively.No complication that affected joint function was found.Conclusion Rivets with thread can be used for treating Tossy Ⅱ & Ⅲ dislocation of acromioclavicular joint.This surgical technique is characterized by small operation wound,fewer complications,no secondary operation,and satisfactory treatment effect.