Comparison of Acute Acromioclavicular Joint Dislocation Treatment by Screw Fixation with and without Ligament Reconstruction

Abstract

Background & Aims: Acute acromioclavicular (AC) joint dislocation is common in shoulder injuries. Considering the biomechanics of this joint, the use of a treatment method, which can restore joint physiology and biomechanics to the extent possible, is important. This study aimed to compare the treatment of acute AC joint dislocation by screw fixation with and without ligament reconstruction. Methods: In the present study, 28 patients with AC joint dislocation type 4, 5, and 6, were randomly treated with either coracoclavicular screw fixation with ligamentous reconstruction or screw fixation without ligament reconstruction. Screws were removed after 8 weeks. The follow-up period lasted for 2 months. The simple shoulder test (SST), disabilities of the arm, shoulder, and hand (DASH) score, and the University of California-Los Angeles (UCLA) shoulder scale were conducted using specific questionnaires. Results: Based on the SST, mean shoulder function was better in the ligament reconstruction group compared to the group without ligament reconstruction (P = 0.028). The result of the UCLA shoulder scale indicate a significantly better returning to original and natural function of the AC joint in the ligament reconstruction group than the other group (P = 0.012). DASH score indicated a significantly lower disability rate in the group that underwent ligament reconstruction than the other group (P = 0.001). Conclusion: The results suggest that ligament reconstruction in the Ac joint significantly increases the rate of returning to normal function, joint stability, and normal joint physiology.

Keywords

• ligamentous reconstruction
• acromioclavicular
• dislocation