Vojnosanitetski pregled 2013 Volume 70, Issue 3, Pages: 292-297
https://doi.org/10.2298/VSP1303292K
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Comparative study of surgical treatment of acromioclavicular luxation
Kezunović Miroslav (Clinical Center of Montenegro, Orthopedic-Traumatologic Clinic, Podgorica, Montenegro)
Bjelica Duško (Faculty of Sport and Physical Education, Nikšić, Montenegro)
Popović Stevo (Faculty of Sport and Physical Education, Nikšić, Montenegro)
Background/Aim. Acromioclavicular (AC) luxations most often affect athletes.
The published results regarding the treatment of AC joint luxations vary.
Each method has its advantages and disadvantages, so there is still no
consensus on the best method of treatment. The aim of this study was to
review the results of a number of surgical approaches to stabilization of AC
joint recorded over the span of five years. Methods. This study was based on
the data acquired from the analysis of 28 patients with AC luxation
surgically treated in the Clinical Center of Montenegro. One group of 16
patients underwent the traditional AO method (with transfixation of AC joint
with Kirschner wire and Zuggurtung tension bands) or the Bosworth method
(using the coracoclaviculartransfixation screw - Zugg-Bosw group). The second
group of 12 patients underwent a newer techinque with the Hook plate (Hook
plate group). Results. All the patients had AC luxation of higher degree,
stage IV-VI acording to the Rockwood scale. The average age of the two groups
was very similar, with 28 being the average age of the Zugg-Bosw group, and
25 of the Hook plate group. Most patients were males (82%), injured mostly
during athletic activity (75%-83%). Complications were more common and more
complex in the Zugg-Bosw group, with 2 early and 8 late comlications. There
are only 3 late complications in the Hook plate group, but with no
significant statistical difference (p = 0.19; t = -1.34; df = 27). With
respect to the subjective patient satisfaction following the treatment, the
Hook plate group gave significantly better evaluations (4.4 ± 0.19)(p =
0.007; t = 2.95; df = 27). Constant score showed no significant statistical
difference (p = 0.078; t = 1.8; df = 27). The Hook plate group had a better
median score (90 ± 0.18) with respect to the Zugg-Bosw group (85 ± 0.40).
Conclusion. The Hook plate method achieved somewhat better results, which
indicate that this method is one of the ways to ensure a strong, stable
fixation of the AC joint without transfixation. At the same time, this method
does not inhibit the ligament healing and allows an early mobilisation.
Keywords: acromioclavicular joint, wounds and injuries, traumatology, surgical procedures, operative, postoperative complications, Montenegro