Conjoined tendon and coracoacromial ligament transfer in the treatment of RockwoodIII acromioclavicular joint dislocation: anatomical and clinical validation

doi:10.3969/j.issn.2095-4344.2015.07.009

Abstract

Abstract:

BACKGROUND: There are many surgical methods for treatment of acromioclavicular joint dislocation. Through various internal fixation materials (such as hook plate, screws, K-wire, etc.), we can achieve the initial stability and restoration of the acromioclavicular joint. But these internal fixators can cause varying degrees of occupancy and damage to the acromioclavicular joint, and the joint reduction often miss after removal of the internal fixators.

OBJECTIVE: To use conjoined tendon and coracoacromial ligament transfer for coracoclavicular ligament reconstruction in the repair of RockwoodIII acromioclavicular joint dislocation, to provide the theoretical foundation through the autopsy, and to analyze the clinical efficacy based on clinical follow-up results.

METHODS: (1) Autopsy morphology research: From September 2012 to November 2012, totally 46 adult cadaveric human shoulders were dissected in the Department of Anatomy, Xinjiang Medical University. The anatomical morphology of the acromioclavicular joint was observed and the relevant morphological parameters of the ligament were measured. (2) Case analysis: Eleven patients who received coracoclavicular ligament reconstruction with the lateral half of the conjoined tendon and medial half of the coracoacromial ligament for repair of RockwoodIII acromioclavicular joint dislocation from 2012 to 2014 were followed up. At the last follow-up visit, postoperative radiographic evaluation was done for the acromioclavicular joint recovery, and the American Shoulder and Elbow Surgeons (ASES) scores, Constant-Murley shoulder scores and UCLA shoulder scores, Simple Shoulder Test Form were adopted to evaluate the shoulder functions; visual analog scale scores were used for pain evaluation.

RESULTS AND CONCLUSION: (1) Results of autopsy morphology research: Detail morphology data of the acromioclavicular joint, its surrounding tissues and musculocutaneous nerve were given, which provide the anatomical data for operation at this region. (2) Result of case analysis: After 2-24 months of follow-up, the mean ASES score was 92.3, the mean Coustant-Murley score was 90.4, the mean UCLA shoulder score was 31.6, and the mean visual analog scale score for pain was 1.4. The number of positive answer to the Simple Shoulder Test Form was 6, and the overall excellent rate was 90.9% (10/11). Poor results were found in one case. Through the anatomical reconstruction of the static stability (such as coracoclavicular ligaments) and dynamic stability (such as joint capsule, trapezius muscle and deltoid muscle) of the acromioclavicular joint, the anatomical reduction of the acromioclavicular joint can be implemented. In a word, the double-beam coracoclavicular ligament reconstruction using the conjoined tendon and coracoacromial ligament is an effective method to repair RockwoodIII acromioclavicular joint dislocation.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

全文链接：

Key words: Shoulder Dislocation, Autopsy, Ligaments, Internal Fixators

CLC Number:

R318

Wang Zhi-zhou, Yilihamu Tuoheti, Xu Chao, Hou Yan-jie, Guo Hong-liang, Gan Zi-ming. Conjoined tendon and coracoacromial ligament transfer in the treatment of RockwoodIII acromioclavicular joint dislocation: anatomical and clinical validation[J]. Chinese Journal of Tissue Engineering Research, 2015, 19(7): 1028-1035.

Figures/Tables 9

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