Acromioclavicular Joint Fixation Using an Acroplate Combined With a Coracoclavicular Screw

Abstract

BACKGROUND: Appropriate treatment of acromioclavicular joint dislocation is controversial. Acroplate fixation is one of the most common treatment methods of acromioclavicular joint (ACJ) dislocation. Based on the risk of re-dislocation after Acroplate fixation, we assumed that combined fixation with an Acroplate and a coracoclavicular screw helps improve the outcome. OBJECTIVES: The main purpose of the current study was to compare the outcome of ACJ dislocation treated with an Acroplate alone and in combination with coracoclavicular screw. PATIENTS AND METHODS: This study was carried out on 40 patients with ACJ dislocation types III to VI who were divided randomly into two equal groups: Acroplate group (P) and Acroplate in combination with coracoclavicular screw group (P + S). The screws were extracted 3-6 months postoperatively. The patients were followed for 1 year and Imatani's score was calculated. Finally, the data were compared between the groups. RESULTS: The mean Imatani's score was significantly higher in P + S group (83.4 +/- 14.1) than P group (81.2 +/- 10.3) (P < 0.001). The mean duration of surgery was the same in the two groups (59.8 +/- 9.4 minutes in group P V.s 64.3 +/- 10.9 minutes in group P + S; P = 0.169). There were no cases of re-dislocation, degenerative changes and ossification and all patients returned to their previous jobs or sporting activities. CONCLUSIONS: Using a coracoclavicular screw combined with an Acroplate can improve the patients' function after ACJ disruption without any significant increase in surgical duration. Authors recommend this technique in the fixation of ACJ dislocation.