Surgical treatment of acute, complete acromioclavicular joint dislocation. Indications, technique and results.
Fremerey RW, Lobenhoffer P, Bosch U, Freudenberg E, Tscherne H. Unfallchirurg 1996 May;99(5):341-5.
From June 1983 to May 1990, 51 patients were operated on for acute, complete acromioclavicular dislocation (Tossy III). The operative technique includes suturing of the coracoclavicular and acromioclavicular ligaments and stabilization of the clavicle with resorbable, 10-mm coracoclavicular PDS banding. Six patients received primary resection of the lateral end of the clavicle due to significant injury of the AC joint cartilage. Forty-two patients with an average follow-up of 6.1 years were evaluated clinically using the UCLA and Constant-Murley Score, as well as subjective grading. Additional radiological assessment was performed in 36 cases. Excellent or good clinical results were obtained in 97.6%, with 85.7% being free of pain. All patients with primary resection of the lateral end of the clavicle had no pain. The incidence of postoperative complications was low (one deep wound infection with removal of the PDS band, three secondary dislocations). Post-traumatic arthritis developed in 14.7% of the patients. In those cases of acute grade III AC joint dislocations where operative treatment is indicated, this technique provides excellent results with a low complication rate.