CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2019; 54(06): 649-656
DOI: 10.1055/s-0039-1697020
Artigo Original
Sociedade Brasileira de Ortopedia e Traumatologia. Published by Thieme Revnter Publicações Ltda Rio de Janeiro, Brazil

Functional and Radiological Outcomes of the Surgical Treatment of Acute Acromioclavicular Dislocation with Anchors Associated with Clavicle and Scapula Fixation[*]

Article in several languages: português | English
1  Departamento de Ortopedia e Traumatologia, Hospital Universitário, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brasil
,
José da Mota Neto
1  Departamento de Ortopedia e Traumatologia, Hospital Universitário, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brasil
,
Darlan Malba Dias
2  Serviço de Ortopedia e Traumatologia, Hospital Santa Luzia, Brasília, DF, Brasil
,
Leandro Furtado de Simoni
3  Hospital Maternidade Therezinha de Jesus, Juiz de Fora, MG, Brasil
,
Elmano de Araújo Loures
1  Departamento de Ortopedia e Traumatologia, Hospital Universitário, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brasil
,
Pedro José Labronici
4  Departamento de Cirurgia, Universidade Federal Fluminense (UFF), Niterói, RJ, Brasil
› Author Affiliations
Further Information

Publication History

15 April 2018

04 June 2018

Publication Date:
23 September 2019 (online)

Abstract

Objective To evaluate the clinical, radiological and functional results of the surgical treatment of acute acromioclavicular dislocation using a coracoclavicular fixation technique (syndesmopexy) with two metallic anchors, temporary clavicle and scapula fixation, and transfer of the coracoacromial ligament.

Methods Longitudinal observational study of 30 patients with diagnoses of acute acromioclavicular dislocation, who were submitted to surgical treatment with a minimum follow-up of six months, and who were evaluated clinically, radiologically, and by the University of California at Los Angeles (UCLA), the Disabilities of the Arm, Shoulder and Hand (DASH) and the Constant-Murley functional scores.

Results The mean values of the scores were: UCLA = 32; DASH = 11.21; and Constant-Murley = 86.93, with satisfactory results higher than 80%. The unsatisfactory results were associated with acromioclavicular pain on palpation, positive subacromial impingement tests, and older age group, presenting statistical significance (p < 0.05). Radiologically, higher values on account of the coracoclavicular distance ratio from the operated shoulder compared to the normal shoulder were related to worse outcomes, but with no statistically significant difference. No associations were found between the results of the functional scores and the variables degree of the injury, coracoacromial ligament transfer, clinical impression of loss of reduction and scapulothoracic dyskinesis.

Conclusion The technique used provides an efficient fixation, with a high level of satisfaction according to the UCLA, Constant-Murley and DASH scores; moreover, it has a low complication rate, despite the high rate of residual radiological acromioclavicular subluxation.

* Study developed at Hospital Universitário, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil