Summary

As the trauma of old AcromioClavicular dislocation has been scar，although surgical treatment was performed，it can also has some complications,such as restoration invalid,limited range of shoulder joint movement

Abstract

Purpose:The purpose of this research is to explore the feasibility and clinical efficacy of old AcromioClavicular dislocation under reconstruction CoracoClavicular ligament and AcromioClavicular ligament with tendon in small incision.
Methods:In May 2015 - September 2016, 6 patients of old AcromioClavicular dislocation were treated in our hospital with reconstruction CoracoClavicular ligament and AcromioClavicular ligament with tendon in small incision, 4 cases were male, female in 2 cases. Preoperative examination: positive piano sign and positive horizontal adduction test, the American Shoulder and Elbow Surgeons(ASES) average score in pre-operation is 26.7 points, the Constant score systems in pre-operation is 26 points. Using allograft tendon reconstruction the CoracoClavicular ligament and AcromioClavicular ligament in intra-operative to restoration the acromioclavicular joint, with 2 Kirschner wires restoration the acromioclavicular joint temporary, hook the posterior collarbone point 4.5cm away from the acromioclavicular joint with positioner, positioning sleeve located in the Coracoid basis area, drill the bone tunnel 1, then drill the bone tunnel 2 in the point of Clavicle center 2.5cm away from the acromioclavicular joint, use tendon and 1 5# Ethibond t hrough the Coracoid basis area with bone tunnel 1,and then from the bone tunnel 2 wear out, knotted the Ethibond in the bone surface, as a guard line, strengthen fixed. Tensioning the tendon , Put an 3.5mm anchor nail in the anterior superior acromion and fixed tendon in acromion, make one bunch fixed at the anterior acromioclavicular joint, one bunch fixed on top of the acromioclavicular joint, recontruction anterior superior acromioclavicular joint capsule, avoid broken acromion surface when Screw the anchor nail, avoid cause the impact. Using 5# Ethibond strap Kirschner wires to strengthen the tension band. Operative time:50-60 mins, average 54 mins, the amount of bleeding is 50ml in average, No nerve vascular injury.

Results

Review Shoulder X-ray in the next day after the operation reveal the acromioclavicular joint reset satisfaction, Postoperative 1, 2, 3, 6 and 12 months follow-up,followed up for 8 months on average. At the time of the last follow-up,6 patients piano sign and horizontal adduction test were negative,5 patients acromioclavicular joint reset satisfaction in the last follow-up,1 patient acromioclavicular joint reset a little lost,but no obvious symptom,100% satisfaction rate. The ASES score of 6 patients is 88.4 points on average, and the Constant score systems is 90.6 points, obviously improved than preoperative.
Conclusion:Reconstruction CoracoClavicular ligament and AcromioClavicular ligament with tendon in small incision to treatment the old AcromioClavicular dislocation is simple to operate,small trauma,have a lot advantages,such as good restoration,strong fixed and less restoration loss in postoperative, and allow early functional exercise activities, obtain fine effect.