Int J Sports Med 1999; 20(8): 560-562
DOI: 10.1055/s-1999-8840
Orthopedics and Clinical Science
Georg Thieme Verlag Stuttgart ·New York

Treatment of Complete Acromioclavicular Dislocation: Present Indications and Surgical Technique with Biodegradable Cords

S. P. Mönig, C. Burger, H. J. Helling, A. Prokop, K. E. Rehm
  • Department of Trauma, Hand and Reconstructive Surgery, Cologne University Hospital, Cologne, Germany
Further Information

Publication History

Publication Date:
31 December 1999 (online)

We report a retrospective study of 48 patients with complete acromioclavicular dislocation (Tossy III). All patients (38 male; 10 female) with an average age of 33.4 years underwent surgery including PDS-augmentation. More than half of the injuries were caused by sport accidents. There were no complications during surgery. 87 % of the patients were free of complaints and subjectively very satisfied with the surgical results. By radiological examination we diagnosed a subluxation of the clavicula in 25 % of the cases and arthrosis in 17 % of the cases. Assessment of subjective complaints, the clinical examination, and the radiological diagnostic according to the Taft Score (0 - 12 points) resulted in an average value of 10.2 points. The surgical intervention using PDS-cord augmentation in cases of complete acromioclavicular separation is a safe and economic method with a low complication rate. Advantages are possible early-functional treatment, no risk of movement of implants, and avoidance of metal removal.

References

  • 1 Bannister G C. The management of acute acromioclavicular dislocation. A randomised prospective controlled trial.  J Bone Joint Surg B. 1989;  71 848-850
  • 2 Fenkl R, Gotzen L. Ultrasound diagnosis of the injured acromio-clavicular joint.  Unfallchirurg. 1992;  95 393-400
  • 3 Fremerey R W, Lobenhoffer P, Bosch U, Freudenberg E, Tscherne H. Operative treatment for acute, complete acromioclavicular dislocations: indication, technique and results.  Unfallchirurg. 1996;  99 341-345
  • 4 Göhring U, Matusewicz A, Friedl W, Ruf W. Behandlungsergebnisse nach unterschiedlichen Operationsverfahren zur Versorgung einer Schultereckgelenksprengung.  Chirurg. 1993;  64 565-571
  • 5 Gollwitzer M. Surgical management of complete acromioclavicular joint dislocation with PDS cord cerclage.  Akt Trauma. 1993;  23 366-370
  • 6 Haas N, Blauth M. Verletzungen des Akromio- und Sternoklavikulargelenkes - operative oder konservative Therapie?.  Orthopäde. 1989;  18 234
  • 7 Hessmann M. Reconstruction of complete acromioclavicular seperations using PDS-banding as augmentation: experience in 64 cases.  Acta Chir Belg. 1995;  95 147-151
  • 8 Keller H W, Rehm K E. Treatment of acromioclavicular dislocation without metallic implants.  Unfallchirurg. 1991;  94 511-513
  • 9 Larsen E, Bjerg-Nielsen A, Christensen P. Conservative or surgical treatment of AC dislocation.  J Bone Joint Surg. 1986;  68-A 552-555
  • 10 Pfahler M, Krödel A, Refior H J. Surgical treatment of acromioclavicular dislocation.  Arch Orthop Trauma Surg. 1994;  113 308-311
  • 11 Rawes M L, Dias J J. Surgical treatment of acromioclavicular dislocation.  Bone Joint Surg. 1996;  78-B 410-412
  • 12 Rehm K E. Versorgung der Schultereckgelenksprengung ohne metallisches Implantat. In: Refior HJ, Plitz W, Jäger M, Hackenbroich MH (eds) Biomechanik der gesunden und kranken Schulter. Stuttgart, New York; Thieme 1985: 47-48
  • 13 Rehm K E, Schultheis K H. Bandersatz mit Polydioxanon (PDS®).  Unfallchirurgie. 1985;  11 264
  • 14 Rockwood C A, Young D C. Disorders of the acromioclavicular joint. In: Rockwood CA, Matsen FA (eds) The shoulder. Philadelphia, London, Toronto; Saunders 1990: 413-476
  • 15 Rüstemeyer M, Kulenkampf H A. Surgical treatment of acromioclavicular separation with a self-resorbing cord of polydioxane.  Unfallchirurgie. 1990;  16 70-74
  • 16 Sim E, Schwarz N, Höcker K, Berzlanovich A. Repair of complete acromioclavicular separations using the acromioclavicular-hook-plate.  Clin Orthop. 1995;  314 134-142
  • 17 Taft T N, Wilson F C, Oglesby J W. Dislocation of the acromioclavicular joint. An end-result study.  J Bone Joint Surg. 1987;  69-A 1045-1051
  • 18 Thelen E, Rehn J. Akromioklavikularsprengungen - Ergebnisse nach operativer und konservativer Versorgung in 162 Fällen.  Unfallheilkunde. 1976;  79 417-422
  • 19 Tossy J D, Sigmond H M. Acromioclavicular separations: useful and practical classification for treatment.  Clin Orthop. 1963;  28 111-119
  • 20 Weinstein D M. Surgical treatment of complete acromioclavicular dislocations.  Am J Sports. 1995;  23 324-331

MD S. P. Mönig

Department of Surgery University of Cologne

Joseph-Smann-Straße 9

D-50924 Cologne

Germany

Phone: +49 (221) 4784803

Fax: +49 (221) 9402923

Email: MoenigSt@aol.com

    >