Chinese Journal of Tissue Engineering Research ›› 2011, Vol. 15 ›› Issue (17): 3212-3216.doi: 10.3969/j.issn.1673-8225.2011.17.041

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Application of suture anchor to treat acromioclavicular dislocation in 20 cases

Yang Shun1, Jiang Chun-yan2, Xiang Ming1, Mou Jian-xiong1, Chen Hang1, Yang Guo-yong1   

  1. 1Department of Upper Extremity Trauma, Orthopedic Hospital of Sichuan Province, Chengdu  610041, Sichuan Province, China
    2Beijing Jishuitan Hospital, Beijing  100035, China
  • Received:2010-12-14 Revised:2011-02-16 Online:2011-04-23 Published:2011-04-23
  • Contact: Jiang Chun-yan, Doctor, Chief physician, Associate professor, Beijing Jishuitan Hospital, Beijing 100035, China chunyanj@hotmail.com
  • About author:Yang Shun, Attending physician, Department of Upper Extremity Trauma, Orthopedic Hospital of Sichuan Province, Chengdu 610041, Sichuan Province, China yangs_666@sina.com

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Abstract:

BACKGROUND: Fixation of acromioclavicular dislocation is difficult and often accompanied with complications in late stage in clinic. There are many disputes about treatment of severe acromioclavicular dislocation.
OBJECTIVE: To introduce the procedure of distal clavicle excision and reconstruction of coracoclavicular ligament with suture anchor to treat acromioclavicular dislocation and to analyze the effect on clinical cases.
METHODS: Twenty cases were followed up from November, 2006 to January, 2009, diagnosed as acromioclavicular dislocation. Radiological evaluation was applied at final follow up. In addition, shoulder function was measured according to UCLA, Constant Scores and Shoulder Concise Questionnaire (SST).
RESULTS: A mean time of 15.6 months (9-26 months) follow-up was completed after surgery. The height of distal clavicle in all patients reached anatomical reduction. The average UCLA score was 33 (28-35), and the average Constant score was 91.6 (82-96).The average forward flexion and elevation was 146.4°, and that of external rotation was 45.6°. Positive answers in SST questionnaire were 12 at average. The rate of excellence and good was 85% (17/20) in common. Positive answers were gained, when the same operative treatment was readily accepted if the same fracture arose at contralateral shoulder. Distal clavicle excision and coracoclavicular ligament reconstruction with suture anchor is an effective method to treat acromioclavicular dislocation resulted from severe trauma. Suture anchor has the advantages of good compatibility and adaptation, reliable fixation with high strength in order to obtain stable early fixation. Distal clavicle excision prevents acromioclavicular arthritis. As a choice of allograft, the lateral half of the conjoined tendon not only have enough length, but also prevent the sacrifice of the coracoacromial ligament, so that the complete coracoacromial arch is reserved. For the patient who has co-exiting rotator cuff injury, the lateral half of the conjoined tendon is a good choice of allograft. Reconstruction of coracoclavical ligament with suture anchor, repair of the coracoclavical ligament and restore the function of the coracoclavical space have the advantages of short operation time, less complication and no need of secondary operation. In combination with postoperative rehabilitative exercises, the function of shoulder can reach original sport level.

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