Complication Folloing Operative Treatment in Complete Acromioclavicular Joint Dislocation

Hwang, Sung Kwan; Ahn, Jae In; Park, Heui Jeon; Cha, Zi Hoan

Abstract

The conservative treatment such as plinting, bandaging and harnessing in the partial disrupton of the acromioclavicular joint(Grade II or less) has been successuful, but many surgeons prefer to operative treaments for complete A-C dislocation(Grade III). Though more than 55 operative methods of treatment were reported in the literature, they could be divided into four categories: 1) acromioclar reduction and acromioclavicular fixation, 2) acromicoclavicular reduction, coracoclavicular ligament repair, and coracoclavicular fixation, 3) distal clavicle excision, and 4) muscle transfers. Among numerous operative methods, we used Weaver-Dunn technic, A-O tension Band technic, and Modified bosworth technic in total 28 cases of complete A-C dislocation from March 1984 to June 1988 at the Yonsei University Wonju College of Medicine, Wonju Christian Hospital. In most cases, excellent or good results were obtained, but we stillfound swveral postperative complications. We experienced neither deep wound infection nor osteomyelitis. All 6 cases had fixation-related complications. After close examination of operation notes and X-rays, following suggestions were considered. 1. Reduce every A-C joint anatomically before inserting K-wires through A-C joints. 2. Start shoulder motion several days after operation to provide enough time form healing of deltoid and trapezius muscles. 3. Surgenous play a major role to prevent commplications such as malposition of fixatives and incomplete A-C joint reduction