Comparison of two coracoclavicular ligament reconstruction combined with hook plate fixation in treatment of acromioclavicular joint dislocation of Rockwood type Ⅲ-Ⅴ / 中国医师进修杂志

ABSTRACT

Objective To compare the clinical outcomes of different coracoclavicular ligament (CCL) reconstruction combined with hook plate fixation in the treatment of acromioclavicular joint (ACJ) dislocation of Rookwood type Ⅲ-Ⅴ. Methods A retrospective study was conducted to evaluate the outcomes of 76 patients with ACJ dislocation of Rockwood type Ⅲ-Ⅴwho had been treated with CCL reconstruction using iliotibial tract fascia graft or palmaris longus tendon in addition to hook plate fixation from January 2012 to March 2016. The patients were divided into 2 groups according to their grafts used in CCL reconstructiongroup A (39 cases using iliotibial tract fascia graft ) and group B (37 cases using palmaris longus tendon iliotibial tract fascia graft). They were firstly treated with CCL reconstruction followed by hook plate fixation. The acromioclavicular and coracoclavicular distances were measured on the postoperative anteroposterior radiographs of the injured shoulders. The outcomes were assessed at the final follow-ups according to Constant-Murley shoulder score and Karlsson criteria. Results The acromioclavicular distances and coracoclavicular distances measured in group A at 12 months after operation were significantly smaller than those measured in group B (4.7 ± 0.7) mm vs. (5.4 ± 1.3) mm, (7.5 ± 1.5) mm vs. (8.5 ± 1.6) mm, P<0.05. At 18 months after operation, the Constant-Murley shoulder scores (92.2 ± 7.3) and Karlsson excellent to good rate 82.1%(32/39) in group A were similar to those in group B (P > 0.05). The total incidence of complications in group A and there showed no statistical difference compared with that of group B (P>0.05). Conclusions In the treatment of ACJ dislocation of Rookwood type Ⅲ-Ⅴ, CCL reconstruction using iliotibial tract fascia graft may lead to better radiographic outcomes than compared with that using palmaris longus tendon, though the 2 grafts lead to similar functional recovery of the injured shoulders.