Background
Dislocation of the acromioclavicular joint (ACJ) is a common orthopedic injury among athletes and victims of motor vehicle accidents, predominantly motorcycle crashes. There is a common view that early surgical management should be recommended for patients with Rockwood types IV-VI ACJ injuries, as it would prevent long-term sequelae, and also it is required for patients with grades III with heavy manual occupations, athletes, and so on. None of the body joints had been treated with such profuse different techniques in an attempt to properly restore its natural situation.
Patients and methods
The present study describes and evaluates a new technique of percutaneous application of temporarily dynamic compression design of tension band wiring in type III, IV, and V acute complete ACJ dislocations. Preserving the already injured ACJ capsule, ligaments, surrounding deltotrapezial fascia, and muscles from open surgical trauma is subsequently presumed to contribute in significant stability. All patients underwent surgical management by percutaneous tension band wiring. Patients were followed up from the viewpoint of functional and radiological results at 2, 6, 12, 18 weeks, and 1 year after surgery.
Results
A total of 30 adult patients were enrolled in the study; one male patient was lost to follow-up at the 12th week appointment (implant extraction); hence, he was excluded from the results. The mean age of the patients was 31.4 years. Overall, 28 were males and two females. Clinical outcomes were regarded as excellent in 25 cases, representing 86.2% (average score=92.65) and good in three cases (average score=85), including a re-wiring case. Two patients (6.8%) experienced partial reduction loss. However, there were no significant differences (=0.236) between the right and left shoulders regarding coracoclavicular distance.
Conclusion
Percutaneous tension band wiring technique has shown to provide satisfactory clinical results and shoulder functions. It provides stable fixation, allows early motion exercise by minimizing surgical trauma to preinjured tissues, lowers the complications of rigid internal fixation, and reduces cosmetic problem in scar.