[Case-control study on clavicular hook plate combined with acromiocoracoid ligament transfer in the treatment of acromioclavicular joint dislocation of type Tossy III in young patients].

Objective:To study the clinical effects of acromiocoracoid ligament transfer to repair coracoclavicular ligament and acromioclavicular ligament in the treatment of acromioclavicular joint dislocation of type TossyⅢin young patients. Methods:From January 2005 to January 2007,52 patients with acromioclavicular joint dislocation of type Tossy Ⅲ were divided into therapeutic groupⅠ(32 cases) and therapeutic groupⅡ(22 cases). There were 17 males and 13 females with an average age of 31.0 years(ranged,19 to 40 years) in groupⅠ;as well as 12 males and 10 females with an average age of 33.6 years(ranged,20 to 42 years) in groupⅡ. All the patients were fresh injury and the acromioclavicular joint dislocations were type Tossy Ⅲ according to X-ray findings. The duration from damage to the operation time ranged from 2 to 17 days(averaged,7.6 days). All the patients had normal shoulder function before injury and were treated with clavicular hook plate implantation. The patients in groupⅡwere treated with normal desmorrhaphy method,and the patients in groupⅠwere treated with acromiocoracoid ligament transfer to repair coracoclavicular ligament and acromioclavicular ligament. Steel plate was taken out at about 4 to 6 months after clavicular hook plate implantation. The results were evaluated according to Karlsson′s standards. Results:All the incisions healed without infection. The therapeutic effects of 52 patients were evaluated at the 6th month after internal fixation was taken out. Twenty-four patients in groupⅠgot an excellent results and 6 good;17 patients in groupⅡgot an excellent results and 5 good. There was no significant difference between the two groups. Twenty-six patients in groupⅠand 19 patients in groupⅡhad long-term follow-up,and the duration ranged from 3 to 5 years(averaged,4.5 years ). Twenty patients in groupⅠgot an excellent results and 6 good;9 patients in groupⅡgot an excellent results,7 good and 3 bad. Three patients in groupⅡhad recurrence of acromioclavicular joint dislocation. The long-term therapeutic effects of groupⅠwas better than that of groupⅡ. Conclusion:After clavicular hook plate implantation in treating type TossyⅢdislocation of the acromioclavicular joint in young patients,it was necessary to use acromiocoracoid ligament transfer to repair coracoclavicular ligament and acromioclavicular ligament,which can improve the stability of acromioclavicular joint to prevent dislocation recurrence.