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DOI: 10.1055/s-1999-8840
Treatment of Complete Acromioclavicular Dislocation: Present Indications and Surgical Technique with Biodegradable Cords
Publication History
Publication Date:
31 December 1999 (online)
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We report a retrospective study of 48 patients with complete acromioclavicular dislocation (Tossy III). All patients (38 male; 10 female) with an average age of 33.4 years underwent surgery including PDS-augmentation. More than half of the injuries were caused by sport accidents. There were no complications during surgery. 87 % of the patients were free of complaints and subjectively very satisfied with the surgical results. By radiological examination we diagnosed a subluxation of the clavicula in 25 % of the cases and arthrosis in 17 % of the cases. Assessment of subjective complaints, the clinical examination, and the radiological diagnostic according to the Taft Score (0 - 12 points) resulted in an average value of 10.2 points. The surgical intervention using PDS-cord augmentation in cases of complete acromioclavicular separation is a safe and economic method with a low complication rate. Advantages are possible early-functional treatment, no risk of movement of implants, and avoidance of metal removal.
Key words:
Acromioclavicular dislocation - PDS-cords - Tossy III - biodegradable material
References
- 1 Bannister G C. The management of acute acromioclavicular dislocation. A randomised prospective controlled trial. J Bone Joint Surg B. 1989; 71 848-850
- 2 Fenkl R, Gotzen L. Ultrasound diagnosis of the injured acromio-clavicular joint. Unfallchirurg. 1992; 95 393-400
- 3 Fremerey R W, Lobenhoffer P, Bosch U, Freudenberg E, Tscherne H. Operative treatment for acute, complete acromioclavicular dislocations: indication, technique and results. Unfallchirurg. 1996; 99 341-345
- 4 Göhring U, Matusewicz A, Friedl W, Ruf W. Behandlungsergebnisse nach unterschiedlichen Operationsverfahren zur Versorgung einer Schultereckgelenksprengung. Chirurg. 1993; 64 565-571
- 5 Gollwitzer M. Surgical management of complete acromioclavicular joint dislocation with PDS cord cerclage. Akt Trauma. 1993; 23 366-370
- 6 Haas N, Blauth M. Verletzungen des Akromio- und Sternoklavikulargelenkes - operative oder konservative Therapie?. Orthopäde. 1989; 18 234
- 7 Hessmann M. Reconstruction of complete acromioclavicular seperations using PDS-banding as augmentation: experience in 64 cases. Acta Chir Belg. 1995; 95 147-151
- 8 Keller H W, Rehm K E. Treatment of acromioclavicular dislocation without metallic implants. Unfallchirurg. 1991; 94 511-513
- 9 Larsen E, Bjerg-Nielsen A, Christensen P. Conservative or surgical treatment of AC dislocation. J Bone Joint Surg. 1986; 68-A 552-555
- 10 Pfahler M, Krödel A, Refior H J. Surgical treatment of acromioclavicular dislocation. Arch Orthop Trauma Surg. 1994; 113 308-311
- 11 Rawes M L, Dias J J. Surgical treatment of acromioclavicular dislocation. Bone Joint Surg. 1996; 78-B 410-412
-
12 Rehm K E.
Versorgung der Schultereckgelenksprengung ohne metallisches Implantat. In: Refior HJ, Plitz W, Jäger M, Hackenbroich MH (eds) Biomechanik der gesunden und kranken Schulter. Stuttgart, New York; Thieme 1985: 47-48 - 13 Rehm K E, Schultheis K H. Bandersatz mit Polydioxanon (PDS®). Unfallchirurgie. 1985; 11 264
-
14 Rockwood C A, Young D C.
Disorders of the acromioclavicular joint. In: Rockwood CA, Matsen FA (eds) The shoulder. Philadelphia, London, Toronto; Saunders 1990: 413-476 - 15 Rüstemeyer M, Kulenkampf H A. Surgical treatment of acromioclavicular separation with a self-resorbing cord of polydioxane. Unfallchirurgie. 1990; 16 70-74
- 16 Sim E, Schwarz N, Höcker K, Berzlanovich A. Repair of complete acromioclavicular separations using the acromioclavicular-hook-plate. Clin Orthop. 1995; 314 134-142
- 17 Taft T N, Wilson F C, Oglesby J W. Dislocation of the acromioclavicular joint. An end-result study. J Bone Joint Surg. 1987; 69-A 1045-1051
- 18 Thelen E, Rehn J. Akromioklavikularsprengungen - Ergebnisse nach operativer und konservativer Versorgung in 162 Fällen. Unfallheilkunde. 1976; 79 417-422
- 19 Tossy J D, Sigmond H M. Acromioclavicular separations: useful and practical classification for treatment. Clin Orthop. 1963; 28 111-119
- 20 Weinstein D M. Surgical treatment of complete acromioclavicular dislocations. Am J Sports. 1995; 23 324-331
MD S. P. Mönig
Department of Surgery University of Cologne
Joseph-Smann-Straße 9
D-50924 Cologne
Germany
Phone: +49 (221) 4784803
Fax: +49 (221) 9402923
Email: MoenigSt@aol.com