Surgical treatments for acute unstable acromioclavicular joint dislocations

被引:2
|
作者
Saraglis, Georgios [1 ]
Prinja, Aditya [2 ]
To, Kendrick [3 ]
Khan, Wasim [3 ]
Singh, Jagwant [1 ]
机构
[1] Lewisham & Greenwich NHS Trust, Dept Trauma & Orthopaed, London SE13 6LH, England
[2] Wrightington Hosp, Upper Limb Unit, Wrightington WN6 9ES, Lancs, England
[3] Univ Cambridge, Dept Surg, Div Trauma & Orthopaed Surg, Cambridge CB2 0QQ, England
来源
SICOT-J | 2022年 / 8卷
关键词
Acromioclavicular joint dislocation; Acromioclavicular joint reconstruction; Hook plate fixation; Coracoclavicular ligament reconstruction; WEAVER-DUNN PROCEDURE; TENDON GRAFT; RECONSTRUCTION; FIXATION; INJURIES; LIGAMENT; MANAGEMENT;
D O I
10.1051/sicotj/2022038
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Introduction: Surgical treatment is usually recommended for acute, high-grade acromioclavicular joint (ACJ) injuries. A wide variety of surgical techniques exist, and the literature does not strongly support one over the other. In this literature review, we describe and compare the results of different surgical treatments for the management of acute unstable ACJ dislocation and aim to guide surgeons on optimal treatment. Materials and methods: A literature review was performed by searching PubMed, Medline, Cochrane, and Embase databases. Seventeen studies met the inclusion criteria and were analyzed. Only studies with comparative data were included. The clinical and radiological outcomes of these studies were reviewed. Results: Seventeen studies were included in this literature review. We found no difference in outcomes between open and arthroscopic procedures. Coracoclavicular ligament (CCL) reconstruction techniques provide better results than the more rigid hook plate fixation. There is no evidence that biologic repair with tendon graft is superior to synthetic grafts. Furthermore, an autograft is not shown to be better than an allograft. Rigid fixation between the clavicle and coracoid and the non-anatomic Weaver-Dunn technique appears less popular in recent literature. The hook plate is associated with subacromial osteolysis, acromial erosion, and the morbidity of a secondary procedure. Discussion: There is a recent increase in publications on the reconstruction of the ACJ after injury, with new techniques focusing on the anatomic reconstruction of the CCLs aiming to restore both vertical and horizontal plane stability of the ACJ using synthetic/biological grafts. Despite the plethora of new techniques introduced, meaningful comparisons are difficult to draw due to the heterogeneity of the treatments used and the outcome measure used to assess the results.
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页数:11
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