Document Detail


Acute grade III and IV acromioclavicular dislocations: outcomes and pitfalls of reconstruction procedures using a synthetic ligament.
MedLine Citation:
PMID:  20863777     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Acromioclavicular dislocation (ACD) is frequent, at 8% of all shoulder traumas. Management in grade III lesions remains controversial. The present study assessed objective and subjective results at medium-term follow-up (mean, 60 months; range, 12-120 mo) in 27 patients managed by Ligastic(®) ligament reconstruction for acute dislocation.
PATIENTS AND METHODS: This is a multicenter, multi-surgeon retrospective study. Between 1998 and 2006, 59 patients were operated on for grade III or IV ACD, in one teaching hospital (Lille, France) and one general hospital (Tourcoing, France). Follow-up was performed by an independent (non-operator) observer. The 27 acute cases followed up underwent comparative bilateral radioclinical shoulder examination. Initial X-ray assessment found 14 grade-III (52%) and 13 grade-IV (48%) dislocations using Patte's classification.
RESULTS: Mean Constant score was significantly lower on the operated side (82.44 vs 90.04; p<0.05). Specific strength analysis, on the other hand, showed no significant difference with the contralateral shoulder. Coracoclavicular distance was significantly greater on the operated side (p<0.05), with and without traction. Periprosthetic osteolysis was found in 24% of cases, and seemed to worsen over follow-up. There were no cases of fracture on osteolysis. There were no cases of sepsis or of implant intolerance. Four patients, however, required surgical revision.
CONCLUSION: In light of literature findings and our own experience, surgery is not to be recommended in grade-III ACD, and the authors have given up use of this device in this group due to the rate of associated osteolysis.
LEVEL OF EVIDENCE: Level IV.
Authors:
O Mares; S Luneau; V Staquet; E Beltrand; P-J Bousquet; C Maynou
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Publication Detail:
Type:  Journal Article; Multicenter Study     Date:  2010-09-21
Journal Detail:
Title:  Orthopaedics & traumatology, surgery & research : OTSR     Volume:  96     ISSN:  1877-0568     ISO Abbreviation:  Orthop Traumatol Surg Res     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2011-03-17     Completed Date:  2011-08-12     Revised Date:  2013-10-31    
Medline Journal Info:
Nlm Unique ID:  101494830     Medline TA:  Orthop Traumatol Surg Res     Country:  France    
Other Details:
Languages:  eng     Pagination:  721-6     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Masson SAS. All rights reserved.
Affiliation:
Orthopedic Department A, Lille University Hospital, Lille 2, France. ololmares@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Acromioclavicular Joint*
Adult
Aged
Arthroplasty / adverse effects*
Dislocations / etiology,  pathology,  surgery*
Female
Follow-Up Studies
Humans
Ligaments, Articular / surgery*
Male
Middle Aged
Osteolysis / etiology
Prostheses and Implants / adverse effects*
Retrospective Studies
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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