Clavicle and coracoid process periprosthetic fractures as late post-operative complications in arthroscopically assisted acromioclavicular joint stabilization
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Arthroscopic-assisted stabilization surgery for acute acromioclavicular joint (ACJ) disruption shows excellent and reliable clinical outcomes. However, characteristic complications such as fracture of the clavicle and coracoid have been reported to occur during the early post-operative period. The main goal of this study was to highlight the occurrence of fractures as a late post-operative complication. The secondary goals were to describe possible fracture morphologies and treatment outcomes.
Patient records from a single surgery centre were searched for all patients presenting with late fracture complication following arthroscopically assisted acromioclavicular stabilization. Medical reports including the operative notes and pre- and post-operative X-rays were reviewed. A telephone interview was conducted with each patient to access the American Shoulder and Elbow Surgeons shoulder score.
A total of four patients presented with late fracture complication following arthroscopic-assisted ACJ stabilization surgery. All patients were males and presented following trauma at a median duration of 19.5 months after the index surgery. Fracture morphology differed between patients; the treatment was conservative in three patients, while one patient underwent osteosynthesis.
Traumatic peri-implant fractures can occur, even 2 years after arthroscopically assisted ACJ reconstruction. This needs to be considered when planning for surgical intervention in acute ACJ disruption, especially in a high-risk population.
Level of evidence
Therapeutic study, Level IV.
KeywordsPeriprosthetic fracture Arthroscopy Acromioclavicular joint Arthroscopic-assisted stabilization Clavicular tunnel widening Late fracture complication
The first author acknowledges the fellowship provided by the Ministry of Health, Malaysia which enabled the attachment at the ATOS Clinic in Munich.
Compliance with ethical standards
Conflict of interest
The authors declare no conflict of interest regarding the present study. MT, PH and FM are consultants for Arthrex INc.
Ethical approval for AC Joint follow up has been achieved from Technical University of Munich—Approval No. 233/14.
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