Skip to main content

Advertisement

SpringerLink
Log in

Importance of additional temporary pin fixation combined coracoclavicular augmentation using a suture button device for acute acromioclavicular joint dislocation

  • Trauma Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

We evaluated the outcomes of coracoclavicular (CC) augmentation using a suture button device with additional temporary pin fixation for acute acromioclavicular (AC) joint dislocation.

Materials and methods

Thirty-six consecutive cases who underwent CC augmentation using TightRope™ (Arthrex, Naples, FL, USA) were included. We temporarily fixed trans-articular pins in the first 10 cases (TA group) and a trans-spine pin in the next 26 cases (TS group). The radiological and clinical outcomes were evaluated at minimum 2 years postoperatively.

Results

The mean follow-up period was 56.7 months (range, 24–84 months). At the final follow-up evaluation, reduction status showed anatomical reduction in 25 cases (69.4 %), slight loss of reduction in seven cases (19.4 %), partial loss of reduction in two cases (5.6 %), and total loss of reduction in two cases (5.6 %). The mean ASES score, UCLA score, and subjective shoulder value were 92.3, 32.9, and 91.6 %, respectively. There were no significant differences between the two groups with respect to the outcomes. Intraoperative complications occurred in three cases (8.3 %) including two cases of failed reduction and one case of technical failure of the implant. Postoperative complications occurred in three cases (8.3 %) including one case of pin tract infection and distal clavicle fracture at the clavicle-hole, one case of reduction loss by severe subsidence of the clavicular button, and one case of shoulder stiffness.

Conclusions

CC augmentation using a suture button device with temporary pin fixation yielded satisfactory radiological and clinical outcomes. These results support that temporary pin fixation for the AC joint may help to protect the AC reduction in the early phase of healing and rigid scar formation when performing CC fixation using a suture button device.

Level of evidence

Level-IV, Retrospective Case Series, Treatment Study.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Balke M, Schneider MM, Shafizadeh S, Bäthis H, Bouillon B, Banerjee M (2015) Current state of treatment of acute acromioclavicular joint injuries in Germany: is there a difference between specialists and non-specialists? Knee Surg Sports Traumatol Arthrosc 23:1447–1452. doi:10.1007/s00167-013-2795-2

    Article  PubMed  Google Scholar 

  2. Beitzel K, Obopilwe E, Chowaniec DM, Niver GE, Nowak MD, Hanypsiak BT, Guerra JJ, Arciero RA, Mazzocca AD (2011) Biomechanical comparison of arthroscopic repairs for acromioclavicular joint instability: suture button systems without biological augmentation. Am J Sports Med 39:2218–2225. doi:10.1177/0363546511416784

    Article  PubMed  Google Scholar 

  3. Beris A, Lykissas M, Kostas- Agnantis I, Vekris M, Mitsionis G, Korompilias A (2013) Management of acute acromioclavicular joint dislocation with a double-button fixation system. Injury 44:288–292. doi:10.1016/j.injury.2013.01.002

    Article  PubMed  Google Scholar 

  4. Cohen G, Boyer P, Pujol N, Hamida Ferjani B, Massin P, Hardy P (2011) Endoscopically assisted reconstruction of acute acromioclavicular joint dislocation using a synthetic ligament. Outcomes at 12 months. Orthop Traumatol Surg Res 97:145–151. doi:10.1016/j.otsr.2010.10.004

    Article  CAS  PubMed  Google Scholar 

  5. Cook JB, Shaha JS, Rowles DJ, Bottoni CR, Shaha SH, Tokish JM (2012) Early failures with single clavicular transosseous coracoclavicular ligament reconstruction. J Shoulder Elbow Surg 21:1746–1752. doi:10.1016/j.jse.2012.01.018

    Article  PubMed  Google Scholar 

  6. Defoort S, Verborgt O (2010) Functional and radiological outcome after arthroscopic and open acromioclavicular stabilization using a double-button fixation system. Acta Orthop Belg 76:585–591

    PubMed  Google Scholar 

  7. El Sallakh SA (2012) Evaluation of arthroscopic stabilization of acute acromioclavicular joint dislocation using the TightRope system. Orthopedics 35:e18–e22. doi:10.3928/01477447-20111122-13

    Article  PubMed  Google Scholar 

  8. Fraser- Moodie JA, Shortt NL, Robinson CM (2008) Injuries to the acromioclavicular joint. J Bone Joint Surg Br 90:697–707. doi:10.1302/0301-620X.90B6.20704

    Article  CAS  PubMed  Google Scholar 

  9. Glanzmann MC, Buchmann S, Audigé L, Kolling C, Flury M (2013) Clinical and radiographical results after double flip button stabilization of acute grade III and IV acromioclavicular joint separations. Arch Orthop Trauma Surg 133:1699–1707. doi:10.1007/s00402-013-1858-7

    Article  PubMed  Google Scholar 

  10. Li X, Ma R, Bedi A, Dines DM, Altchek DW, Dines JS (2014) Management of acromioclavicular joint injuries. J Bone Joint Surg Am 96:73–84. doi:10.2106/JBJS.L.00734

    Article  CAS  PubMed  Google Scholar 

  11. Lim YW, Sood A, van Riet RP (2007) Acromioclavicular joint reduction, repair and reconstruction using metallic buttons-early results and complications. Tech Shoulder Elbow Surg 8:213–221. doi:10.1097/bte.0b013e3181578965

    Article  Google Scholar 

  12. Mayr E, Braun W, Eber W, Rüter A (1999) Treatment of acromioclavicular joint separations. Central Kirschner- wire and PDS-augmentation. Unfallchirurg 102:278–286

    Article  CAS  PubMed  Google Scholar 

  13. Motta P, Maderni A, Bruno L, Mariotti U (2011) Suture rupture in acromioclavicular joint dislocations treated with flip buttons. Arthroscopy 27:294–298. doi:10.1016/j.arthro.2010.09.009

    Article  PubMed  Google Scholar 

  14. Murena L, Vulcano E, Ratti C, Cecconello L, Rolla PR, Surace MF (2009) Arthroscopic treatment of acute acromioclavicular joint dislocation with double flip button. Knee Surg Sports Traumatol Arthrosc 17:1511–1515. doi:10.1007/s00167-009-0838-5

    Article  CAS  PubMed  Google Scholar 

  15. Richards A, Tennent TD (2008) Arthroscopic stabilization of acute acromioclavicular joint dislocation using the tightrope system. Tech Shoulder Elbow Surg 9:51–54. doi:10.1097/bte.0b013e31816624b6

    Article  Google Scholar 

  16. Schliemann B, Rosslenbroich SB, Schneider KN, Theisen C, Petersen W, Raschke MJ, Weimann A (2015) Why does minimally invasive coracoclavicular ligament reconstruction using a flip button repair technique fail? An analysis of risk factors and complications. Knee Surg Sports Traumatol Arthrosc 23:1419–1425. doi:10.1007/s00167-013-2737-z

    Article  PubMed  Google Scholar 

  17. Shin S-J, Kim N-K (2015) Complications after arthroscopic coracoclavicular reconstruction using a single adjustable-loop-length suspensory fixation device in acute acromioclavicular joint dislocation. Arthroscopy 31:816–824. doi:10.1016/j.arthro.2014.11.013

    Article  PubMed  Google Scholar 

  18. Spiegl UJ, Smith SD, Euler SA, Dornan GJ, Millett PJ, Wijdicks CA (2014) Biomechanical consequences of coracoclavicular reconstruction techniques on clavicle strength. Am J Sports Med 42:1724–1730. doi:10.1177/0363546514524159

    Article  PubMed  Google Scholar 

  19. Tauber M (2013) Management of acute acromioclavicular joint dislocations: current concepts. Arch Orthop Trauma Surg 133:985–995. doi:10.1007/s00402-013-1748-z

    Article  PubMed  Google Scholar 

  20. Venjakob AJ, Salzmann GM, Gabel F, Buchmann S, Walz L, Spang JT, Vogt S, Imhoff AB (2013) Arthroscopically assisted 2-bundle anatomic reduction of acute acromioclavicular joint separations: 58-month findings. Am J Sports Med 41:615–621. doi:10.1177/0363546512473438

    Article  PubMed  Google Scholar 

  21. Walz L, Salzmann GM, Fabbro T, Eichhorn S, Imhoff AB (2008) The anatomic reconstruction of acromioclavicular joint dislocations using 2 TightRope devices: a biomechanical study. Am J Sports Med 36:2398–2406. doi:10.1177/0363546508322524

    Article  PubMed  Google Scholar 

  22. Wang Y, Zhang J (2013) Surgical treatment of fresh complete acromioclavicular dislocation by coracoid process transfer and k-wire transfixation. Indian J Surg 75:436–439. doi:10.1007/s12262-012-0605-6

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopedic Surgery, Dongsan Medical Center, School of Medicine, Keimyung University, 56 Dalseong-ro, Jung-gu, Daegu, 700-712, Korea

    Chul-Hyun Cho, Beom-Soo Kim & Doo-Hyun Kwon

Authors
  1. Chul-Hyun Cho
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Beom-Soo Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Doo-Hyun Kwon
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Chul-Hyun Cho.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cho, CH., Kim, BS. & Kwon, DH. Importance of additional temporary pin fixation combined coracoclavicular augmentation using a suture button device for acute acromioclavicular joint dislocation. Arch Orthop Trauma Surg 136, 763–770 (2016). https://doi.org/10.1007/s00402-016-2437-5

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00402-016-2437-5

Keywords

Search

Navigation