Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
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Clinical and Radiologic Outcomes of Acute Acromioclavicular Joint Dislocation: Comparison of Kirschner's Wire Transfixation and Locking Hook Plate Fixation

  • Rhee, Yong Girl (Shoulder and Elbow Clinic, Department of Orthopaedic Surgery, Kyung Hee University School of Medicine) ;
  • Park, Jung Gwan (Shoulder and Elbow Clinic, Department of Orthopaedic Surgery, Kyung Hee University School of Medicine) ;
  • Cho, Nam Su (Shoulder and Elbow Clinic, Department of Orthopaedic Surgery, Kyung Hee University School of Medicine) ;
  • Song, Wook Jae (Shoulder and Elbow Clinic, Department of Orthopaedic Surgery, Kyung Hee University School of Medicine)
  • Received : 2014.07.04
  • Accepted : 2014.10.24
  • Published : 2014.12.30
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Abstract

Background: Kirschner's wire (K-wire) transfixation and locking hook plate fixation techniques are widely used in the treatment of acute acromioclavicular joint (ACJ) dislocation. The purpose of this study was to compare the clinical and radiologic outcomes between K-wires transfixation and a locking hook plate fixation technique. Methods: Seventy-seven patients with acute ACJ dislocation managed with K-wire (56 shoulders) and locking hook plate (21 shoulders) were enrolled for this study. The mean follow-up period was 61 months. Results: At the last follow-up, the shoulder rating scale of the University of California at Los Angeles (UCLA) was higher in patients treated with locking hook plate than with K-wires ($33.2{\pm}2.7$ vs. $31.3{\pm}3.4$, p=0.009). In radiologic assessments, coracoclavicular distance (CCD) (7.9 mm vs. 7.7 mm, p=0.269) and acromioclavicular distance (ACD) (3.0 mm vs. 1.9 mm, p=0.082) were not statistically different from contralateral unaffected shoulder in locking hook plate fixation group, but acromioclavicular interval (ACI) was significant difference. However, there were significant differences in ACI, CCD, and ACD in K-wire fixation group (p<0.001). Eleven complications (20%) occurred in K-wire transfixation group and 2 subacromial erosions on computed tomography scan occurred in locking hook plate fixation group. Conclusions: ACJ stabilization was achieved in acute ACJ dislocations treated with K-wires or locking hook plates. Locking hook plate can provide higher UCLA shoulder score than K-wire and maintain CCD, and ACD without ligament reconstruction. K-wire transfixation technique resulted in a higher complication rate than locking hook plate.

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References

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