Surgical treatment results of acute acromioclavicular injuries

  Abstract   Background: Different methods of surgical treatment for acromioclavicular(AC)   joint injury were considered in the literature. The purpose of the study was to compare intra- articular AC repair technique with the extra-articular coracoclavicular repair technique for the patients with Rockwood type III and VAC joint injury when indicated.   Methods: Nineteen consecutive patients with Rockwood type III and VAC joint injury   were treated with intra-articular (Group I - 12 cases) and extra-articular (Group II - 7   cases) repair technique between 1380 - 1386, and the results reviewed. When the diagnosis was established, the mean age of the patients was 32.5 years (Range, 18 - 60) group I and II 31.8 years (Range, 18 - 60) and 34 years (Range, 22 - 58) respectively. The mean duration of postoperative follow - up was 24 months. The Constant shoulder scoring system was applied to obtain clinical results.   Results: Only in group I, the post-surgical complication was associated with fiber allergy, wound infection and pin site infection in two patients respectively. No pain was detected in fourteen cases. Four patients in group I had occasional mild pain during sport activity, while one case in this group reported severe pain during resting which prevented the patient from activity. Also, there was an ossification in thirteen patients particularly in group I. Clinical results showed the mean constant shoulder score was 93.4 in group I and 97.1 in group II.   Conclusion: At the time of the follow - up, there was a clear difference between both   groups regarding to postoperative pain and discomfort. Therefore, it seemed that potential cause of pain was due to postoperative complications. An interesting postoperative complication without interfere in the functional outcome was coracoclavicular space ossification in most cases. This was probably because of soft tissue injury during the operation. It seemed that surgical treatment of Rockwood type III and VAC joint injuries when indicated had acceptable clinical results particularly if the extra-articular AC repair technique (screw fixation) was chosen. The new arthroscopic surgical technique with endobutton may decrease the rate of complications such as fracture site ossification and morbidity although more study in this field is required.