EFFECTIVENESS OF CLAVICULAR HOOK PLATE COMBINED WITH TRAPEZIUS MUSCLE FASCIA FOR RECONSTRUCTION OF ACROMIOCLAVICULAR AND CORACOCLAVICULAR LIGAMENTS TO TREAT COMPLETE ACROMIO-CLAVICULAR JOINT DISLOCATION_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 WANGChaoliang ^1,2 , WANGYingzhen ³ , ZHUTao ² , SUNXuesheng ² , LINChu ² , GAOBo ² , LIXinxia ²

1. Medical College of Qingdao University, Qingdao Shandong, 266003, P. R. China;
2. Department of Orthopaedic Surgery, the Affiliated Laiwu Hospital of Taishan Medical College;
3. Department of Joint Surgery, the Affiliated Hospital of Medical College of Qingdao University;

Corresponding?author：

WANGChaoliang, Email: lwwcl2003@163.com

Keywords：

Acromioclavicular joint dislocation; Ligament reconstruction; Clavicular hook plate; Complication

DOI：

10.7507/1002-1892.20150032

Video：

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Objective To explore the effectiveness of the clavicular hook plate combined with trapezius muscle fascia for reconstruction of acromioclavicular and coracoclavicular ligaments to treat acute complete acromioclavicular dislocations. Methods Between January 2008 and April 2012, 66 patients with acromioclavicular dislocation were treated with the clavicular hook plate combined with trapezius muscle fascia for reconstruction of acromioclavicular and coracoclavicular ligaments in 32 cases (experimental group) and with the clavicular hook plate in 34 cases (control group). There was no significant difference in gender, age, injured side, the cause of injury, and the time from injury to operation between 2 groups (P>0.05). Visual analogue scale (VAS), Constant shoulder scores, and coracoid clavi-cledistance (CC.Dist) were measured at preoperation and at 2 years after operation. Signal/noise quotiem (SNQ) was measured by MRI at 2 years after operation. The operation complications were observed. Results The patients of 2 groups obtained primary healing of incision. The morbidity of complication in experimental group (12.5%, 4/32) was significantly lower than that in control group (91.2%, 31/34) (χ²=40.96, P=0.00). All the cases were followed up 2.8 years on average (range, 2 to 4 years). VAS scores and CC.Dist significantly decreased at 2 years after operation when compared with preoperative values in the 2 groups (P<0.05). VAS scores and CC.Dist of the experimental group were significantly lower than those in the control group (P<0.05). According to Constant shoulder scores at 2 years after operation, the results were excellent in 19 cases, good in 11 cases, and general in 2 cases with an excellent and good rate of 93.75% in the experimental group; the results were excellent in 7 cases, good in 8 cases, general in 16 cases, and poor in 3 cases with an excellent and good rate of 44.11% in the control group; and significant difference was shown between 2 groups (t=2.30, P=0.03). SNQ was significantly lower in experimental group than in control group at 2 years after operation (t=55.03, P=0.00), indicating that ligament healing was better in experimental group than control group. Conclusion Compared with simple clavicular hook plate fixation, the clavicular hook plate combined with trapezius muscle fascia for reconstruction of acromioclavicular and coracoclavicular ligaments is successful in treating acute complete acromioclavicular dislocations, with the advantages of higher ligament healing, less complication, and early improvement of shoulder functions.

Citation： WANGChaoliang, WANGYingzhen, ZHUTao, SUNXuesheng, LINChu, GAOBo, LIXinxia. EFFECTIVENESS OF CLAVICULAR HOOK PLATE COMBINED WITH TRAPEZIUS MUSCLE FASCIA FOR RECONSTRUCTION OF ACROMIOCLAVICULAR AND CORACOCLAVICULAR LIGAMENTS TO TREAT COMPLETE ACROMIO-CLAVICULAR JOINT DISLOCATION. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(2): 149-153. doi: 10.7507/1002-1892.20150032 Copy

1.	Kim AC, Matcuk G, Patel D, et al. Acromioclavicular joint injuries and reconstructions:a review of expected imaging findings and potential complications. Emerg Radiol, 2012, 19(5):399-413.
2.	Kim S, Blank A, Strauss E. Management of type 3 acromioclavicular joint dislocations-current controversies. Bull Hosp Jt Dis (2013), 2014, 72(1):53-60.
3.	Lim YW. Triple endobutton technique in acromioclavicular joint reduction and reconstruction. Ann Acad Med Singapore, 2008, 37(4):294-299.
4.	黃高, 王金華, 孔建中. 肩鎖關節脫位的診斷與治療. 創傷外科雜志, 2012, 14(4):369-372.
5.	劉松, 秦士吉, 張英澤. 肩鎖關節脫位的手術治療進展. 中華創傷骨科雜志, 2013, 15(4):349-351.
6.	Hohmann E, Hansen T, Tetsworth K. Treatment of Neer type II fractures of the lateral clavicle using distal radius locking plates combined with TightRope augmentation of the coraco-clavicular ligaments. Arch Orthop Trauma Surg, 2012, 132(10):1415-1421.
7.	Constant CR, Murley AH. A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res, 1987, (214):160-164.
8.	Pavlik A, Csépai D, Hidas P. Surgical treatment of chronic acromioclavicular joint dislocation by modified Weaver-Dunn procedure. Knee Surg Sports Traumatol Arthrosc, 2001, 9(5):307-312.
9.	Weiler A, Peters G, M?urer J, et al. Biomechanical properties and vascularity of an anterior cruciate ligament graft can be predicted by contrast-enhanced magnetic resonance imaging. A two-year study in sheep. Am J Sports Med, 2001, 29(6):751-761.
10.	齊隆輝, 肖智林, 李康貴, 等. AO鎖骨鉤鋼板內固定治療肩鎖關節脫位. 實用骨科雜志, 2012, 18(3):253-254.
11.	吳曉明, 高偉, 李凡, 等. 鎖骨鉤鋼板內固定術后并發癥分析與防治對策. 中華骨科雜志, 2012, 32(4):331-338.
12.	王海明, 劉燕潔, 陳云豐, 等. 三鈕扣鋼板技術與AO鎖骨鉤鋼板治療急性完全性肩鎖關節脫位的中期療效比較. 中華創傷骨科雜志, 2014, 16(1):23-28.
13.	Di Francesco A, Zoeeali C, Colafarina O, et al. The use of hook plate in type Ⅲ and V acromio-clavicular Rockwood dislocations:clinical and radiological midterm results and MRI evaluation in 42 patients. Injury, 2012, 43(2):147-152.
14.	Fukuda K, Craig EV, An KN, et al. Biomechanical study of the ligamentous system of the acromioclavicular joint. J Bone Joint Surg (Am), 1986, 68(3):434-440.
15.	Yoo JC, Ahn JH, Yoon JR, et al. Clinical results of single-tunnel coracoclavicular ligament reconstruction using autogenous semitendi-nosus tendon. Am J Spods Med, 2010, 38(5):950-957.
16.	Epstein D, Day M, Rokito A. Current concepts in the surgical management of acromioclavicular joint injuries. Bull NYU Hosp Jt Dis, 2012, 70(1):11-24.
17.	葉暉, 林其仁, 王文懷, 等. 同種異體肌腱結合錨釘重建喙鎖韌帶治療急性肩鎖關節脫位. 中華手外科雜志, 2014, 30(4):265-267.
18.	Kumar V, Garg S, Elzein I, et al. Modified Weaver-Dunn procedure versus the use of a synthetic ligament for acromioclavicular joint reconstruction. J Orthop Surg (Hong Kong), 2014, 22(2):199-203.
19.	Harris RI, Wallace AL, Harper GD, et al. Structural properties of the intact and the reconstructed coracoclavicular ligament complex. Am J Sport Med, 2000, 28(1):103-108.

1. Kim AC, Matcuk G, Patel D, et al. Acromioclavicular joint injuries and reconstructions:a review of expected imaging findings and potential complications. Emerg Radiol, 2012, 19(5):399-413.
2. Kim S, Blank A, Strauss E. Management of type 3 acromioclavicular joint dislocations-current controversies. Bull Hosp Jt Dis (2013), 2014, 72(1):53-60.
3. Lim YW. Triple endobutton technique in acromioclavicular joint reduction and reconstruction. Ann Acad Med Singapore, 2008, 37(4):294-299.
4. 黃高, 王金華, 孔建中. 肩鎖關節脫位的診斷與治療. 創傷外科雜志, 2012, 14(4):369-372.
5. 劉松, 秦士吉, 張英澤. 肩鎖關節脫位的手術治療進展. 中華創傷骨科雜志, 2013, 15(4):349-351.
6. Hohmann E, Hansen T, Tetsworth K. Treatment of Neer type II fractures of the lateral clavicle using distal radius locking plates combined with TightRope augmentation of the coraco-clavicular ligaments. Arch Orthop Trauma Surg, 2012, 132(10):1415-1421.
7. Constant CR, Murley AH. A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res, 1987, (214):160-164.
8. Pavlik A, Csépai D, Hidas P. Surgical treatment of chronic acromioclavicular joint dislocation by modified Weaver-Dunn procedure. Knee Surg Sports Traumatol Arthrosc, 2001, 9(5):307-312.
9. Weiler A, Peters G, M?urer J, et al. Biomechanical properties and vascularity of an anterior cruciate ligament graft can be predicted by contrast-enhanced magnetic resonance imaging. A two-year study in sheep. Am J Sports Med, 2001, 29(6):751-761.
10. 齊隆輝, 肖智林, 李康貴, 等. AO鎖骨鉤鋼板內固定治療肩鎖關節脫位. 實用骨科雜志, 2012, 18(3):253-254.
11. 吳曉明, 高偉, 李凡, 等. 鎖骨鉤鋼板內固定術后并發癥分析與防治對策. 中華骨科雜志, 2012, 32(4):331-338.
12. 王海明, 劉燕潔, 陳云豐, 等. 三鈕扣鋼板技術與AO鎖骨鉤鋼板治療急性完全性肩鎖關節脫位的中期療效比較. 中華創傷骨科雜志, 2014, 16(1):23-28.
13. Di Francesco A, Zoeeali C, Colafarina O, et al. The use of hook plate in type Ⅲ and V acromio-clavicular Rockwood dislocations:clinical and radiological midterm results and MRI evaluation in 42 patients. Injury, 2012, 43(2):147-152.
14. Fukuda K, Craig EV, An KN, et al. Biomechanical study of the ligamentous system of the acromioclavicular joint. J Bone Joint Surg (Am), 1986, 68(3):434-440.
15. Yoo JC, Ahn JH, Yoon JR, et al. Clinical results of single-tunnel coracoclavicular ligament reconstruction using autogenous semitendi-nosus tendon. Am J Spods Med, 2010, 38(5):950-957.
16. Epstein D, Day M, Rokito A. Current concepts in the surgical management of acromioclavicular joint injuries. Bull NYU Hosp Jt Dis, 2012, 70(1):11-24.
17. 葉暉, 林其仁, 王文懷, 等. 同種異體肌腱結合錨釘重建喙鎖韌帶治療急性肩鎖關節脫位. 中華手外科雜志, 2014, 30(4):265-267.
18. Kumar V, Garg S, Elzein I, et al. Modified Weaver-Dunn procedure versus the use of a synthetic ligament for acromioclavicular joint reconstruction. J Orthop Surg (Hong Kong), 2014, 22(2):199-203.
19. Harris RI, Wallace AL, Harper GD, et al. Structural properties of the intact and the reconstructed coracoclavicular ligament complex. Am J Sport Med, 2000, 28(1):103-108.

Chinese Journal of Reparative and Reconstructive Surgery

EFFECTIVENESS OF CLAVICULAR HOOK PLATE COMBINED WITH TRAPEZIUS MUSCLE FASCIA FOR RECONSTRUCTION OF ACROMIOCLAVICULAR AND CORACOCLAVICULAR LIGAMENTS TO TREAT COMPLETE ACROMIO-CLAVICULAR JOINT DISLOCATION

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