Comparison Between Two Surgical Techniques Acromioclavicular Tension Band Wiring and Coracoclavicular Screw in Acromioclavicular Dislocations

Background: Acromioclavicular (AC) joint dislocations are common in young, active patients and frequently treated in clinical practice.There are many surgical treatments for acro-mioclavicular joint dislocation. The goal of this study was comparing the functional andclinical post-operative results between two urgical techniques, acromioclavicular tension band wiring and coracoclavicular screw inacromioclavicular dislocations. Patients and Methods: 20 patients with Rockwood dislocation type III and more referred to Kamyab Hospital from February 2012 toNovember 2013. They were assessed in terms of surgical indications. The patients were divided in to two groups and the authors usedtension band wiring and screw fixation procedures for each group. Coracoclavicular ligaments were repaired in both techniques. In 1, 6and 12- month follow-up periods, we assessed clinically the acromiomclavicular stability, articular range of motion, VAST score and Oxfordshoulder score with stress radiography. The results were then analyzed statistically. Results: Mean age of the patients was 34 ± 8.1 years and 80% were male. Totally, 17 patients (85%) were type 3 Rockwood and 3 patients(15%) were type 5. Full stability was obtained in all patients by comparing the stress radiography and the post-operative ones. About 50%of patients had Oxford shoulder score (OSS) 42-48. 13 patients (65%) did not complain of any pain and 25% had moderate VAST score (4-7).17 patients (85%) had range of motion more than 150-180. Using t-Student test, no significant difference in type of Rockwood, articularstability, range of motion, OSS score and VAST SCORE was seen between the two groups (P > 0.05). Conclusions: Bosworth screw and Tension band wiring are both useful procedures in patients with ACJ dislocation, but each should beused in the selected patients with special indications. Both methods had good results during follow-up period. There was not statisticallymeaningful difference in the articular stability, range of motion, OSS score and VAST SCORE between the two groups (P > 0.05).

Keywords:

Acromioclavicular , Shoulder , Tension Band Wiring , Screw