Mid-term results after operative treatment of rockwood grade III-V Acromioclavicular joint dislocations with an AC-hook-
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52 Eur J Med Res (2011) 16: 52-56
february 24, 2011 © I. Holzapfel Publishers 2011
MId-TERM REsulTs afTER OPERaTIvE TREaTMEnT Of ROckwOOd GRadE III-v acROMIOclavIculaR JOInT dIslOcaTIOns wITH an ac-H OOk -P laTE B. kienast1, R. Thietje1, c. Queitsch1, J. Gille 2, a. P. schulz 2, J. Meiners1 1department of Traumatology, Orthopaedics and sports Medicine, BG Trauma centre Hamburg, Germany 2 department of Traumatology, Orthopaedic & Reconstructive surgery, university of schleswig-Holstein, campus luebeck,
Abstract acromioclavicular joint dislocations often occur in athletic, young patients after blunt force to the shoulder. several static and dynamic operative procedures with or without primary ligament replacement have been described. Between february 2003 and March 2009 we treated 313 patients suffering from Rockwood III-v lesions of the ac joint with an ac-hook plate. 225 (72 %) of these patients could be followed up. Mean operation time was 42 minutes in the conventional group and 47 minutes in the minimal invasive group. The postoperative pain on a scale from 1 to 10 (vas-scale) was rated 2.7 in the conventional group and 2.2 in the minimal invasive group. Taft score showed very good and good results in 189 patients (84%). constant score showed an average of 92.4 of 100 possible points with 89 % excellent and good results and 11 % satisfying results. all patients had some degree of pain or discomfort with the hookplate in place. These symptoms were relieved after removal of the plate. The overall complication rate was 10.6 %. There were 6 superficial soft tissue infections, 1 fracture of the acromion, 7 redislocations after removal of the hook-plate. we observed 4 broken hooks which could be removed at the time of plate removal, 4 seromas and 2 cases of lateral clavicle bone infection, which required early removal of the plate. we can conclude that clavicle hook plate is a convenient device for the surgical treatment of Rockwood Grade III-v dislocations, giving good mid-term results with a low overall complication rate compared to the literature. Early functional therapy is possible and can avoid limitations in postoperative shoulder function. Key words: acromioclavicular luxation, ac-hook plate, mid-term results, Rockwood III-v
InTROducTIOn acromioclavicular joint dislocations and fractures of the lateral end of the clavicle are common injuries in orthopaedic surgery and sports medicine. These injuries often occur in athletic, young patients after blunt force to the shoulder [1]. while conservative treatment is the option of choice for Rockwood Type I and II
Germany
acromioclavicular injuries and most fractures of the shaft and the medial part of the clavicle, operative treatment is still discussed controversially for Rockwood type III injuries and is the option of choice for type Iv - vI injuries and Jaeger and Breitner type IIa fractures of the lateral clavicle [1-5]. Reason for the instability that lead to a relative dislocation of the lateral clavicle is the involvement of the coracoclavicular ligaments
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