Comparison of arthroscopy-assisted Tightrope technique and clavicular hook plating for acromioclavicular joint dislocation of Rockwood type Ⅲ / 中华创伤骨科杂志

ABSTRACT

Objective To compare the clinical outcomes of arthroscopy-assisted Tightrope technique and clavicular hook plating for the treatment of acromioclavicular joint dislocation of Rockwood Type Ⅲ in aduhs.Methods The clinical data were reviewed of the 60 patients who had been treated for acromioclavicular joint dislocation of Rockwood Type Ⅲ from January 2012 to December 2015 at Department of Orthopedics,Jinhua Municipal Central Hospital.Their age ranged from 34 to 62 years (mean,40 years).Injury was at the left side in 28 cases and at the right in 32 ones.They were randomly assigned to receive treatment either using arthroscopy-assisted Tightrope technique (group A,30 cases) or using clavicular hook plate (group B,30 cases).The 2 groups were compared in terms of incision length,operation time,blood loss,visual analogue scale (VAS) and Constant-Murley shoulder function scores at postoperative 3 and 12 months.Results The 2 groups were compatible because there were no significant between-group differences in gender,age,injury laterality,Rockwood fracture typing or injury cause (P ＞ 0.05).All the patients were followed up for a mean of 10 months (from 6 to 12 months).Primary incision healing was achieved in both groups with no neural lesion.The incision length in group A (3.4 ± 0.6 cm) was significantly shorter than that in group B (8.8 ± 1.8 cm),and the blood loss in the former (40.0 ± 8.2 mL) significantly less than that in the latter (70.9 ± 9.8 mL) (P ＜ 0.05).The VAS scores and Constant-Murley shoulder function scores at postoperative 3 and 12 months in group A (respectively2.2±1.1 and 1.1 ±0.9 points;85.5±2.1 and 98.0±3.1points) were significantly better than those in group B (respectively3.2 ± 1.8 and 2.1 ± 1.2 points;75.0 ±4.1 and 85.1 ±2.9 points) (P ＜ 0.05).There were no obvious complications during the follow-up period in either group.Conclusions Although both arthroscopy-assisted Tightrope technique and clavicular hook plating can relieve shoulder pain in the adult patients with acromioclavicular joint dislocation of Rockwood Type Ⅲ,the former shows advantages of a smaller incision,less bleeding,lower VAS scores,and reduced pain and financial cost for the patients due to no trouble of implant removal.