Minimally invasive reconstruction of coracoclavicular ligament with adjustable locking TightRope for Rockwood type Ⅲ acromioclavicular joint dislocation / 中华创伤杂志

ABSTRACT

Objective To investigate the clinical effect of minimally invasive reconstruction of coracoclavicular ligament with adjustable locking TightRope on treating Rockwood type Ⅲ acromioclavicular joint dislocation.Methods A retrospective case control study was conducted to analyze the clinical data of 62 patients with Rockwood type Ⅲ acromioclavicular dislocation admitted to the Traditional Chinese Medicine Hospital of Wuxi from January 2015 to January 2018.There were 34 males and 28 females,aged 18-71 years,with an average age of 43.7 years.Among the patients,32 were treated with minimally invasive reconstruction of coracoclavicular ligament with adjustable locking TightRope (TightRope group),and 30 with conventional double Endobutton technique (Endobutton group).The operation incision size,operation time,intraoperative blood loss,Constant-Murley score of shoulder joint function and postoperative complications were compared between the two groups.Results All patients were followed up for 6-14 months,with an average of 10.4 months.Compared with Endobutton group,TightRope group had smaller incision size [(1.6 ± 0.9) cm vs.(7.7 ± 2.6) cm],shorter operation time [(45.7 ± 21.1) minutes vs.(58.3 ± 16.7) minutes],and less bleeding during operation [(12.2 ±7.3) ml vs.(76.6 ± 12.2) ml],and the differences were statistically significant (P ＜ 0.05).The Constant-Murley scores of the two groups were significantly improved after operation (P ＜0.05),and there was no significant difference between the two groups in the Constant-Murley score 6 months after operation (P ＞ 0.05).In the Endobutton group,two patients had partial reduction loss of acromioclavicular joint caused by loosening of internal fixation,which was not dealt with because of no symptom,and one patient had coracoid fracture 1 month after operation which was treated with clavicular hook plate fixation.There was no related complication in the TightRope group.Conclusion For Rockwood type Ⅲ acromioclavicular joint dislocation,minimally invasive reconstruction of coracoclavicular ligament with adjustable locking TightRope shows the advantages of small incision,short operation time,and less bleeding,which is worthy of clinical application.