Triple endobutton technique versus AO locking hook-plate for treatment of acuteacromioclavicular joint dislocation

Objective To compare the mid-term clinical outcomes of triple endobutton technique and AO locking hook-plate in the treatment of patients with acute complete dislocation of the acromioclavicular joint.Methods From March 2008 to May 2011,48 patients with acute acromioclavicular joint dislocation (Rockwood types Ⅲ-V) were subjected to surgical treatment.They were 43 men and 5 women,with a mean age of 43.2 years (from 25 to 66 years).They received coracoclavicular ligament reconstruction using triple endobutton technique (24 patients) or using AO locking hook-plate (24 patients).The 2 groups were compared at 3 months,1 and 2 years postoperation in terms of Constant score for the shoulder,visual analog scale (VAS) and complications of the shoulder.The 2 groups were not significantly different in general clinical data(P ＞ 0.05).Results The patients were followed up for 24 to 41 months (average,34.0 months).The average surgical time for the endobutton group (138.7 ± 36.7 min) was significantly longer than that for the hook-plate group (43.1 ± 15.7 min) (P ＜ 0.05).At 3-month follow-up,the Constant score (88.5 ± 8.4) and VAS score (0.4 ±0.7) in the endobutton group were both significantly better than those (65.3 ± 18.3,1.7 ± 1.0) in the hook-plate group(P ＜ 0.05).According to Constant score at 2 years postoperation,the endobutton group and the hook-plate group had no significant difference regarding the good to excellent rates (95.8％ versus 100％) (P ＞ 0.05).Four cases of loosening acromioclavicular joint occurred in both groups respectively; one and 3 cases of dislocation relapse were found in the 2 groups respectively.Conclusions Both triple endobutton technique and AO locking hook-plate are effective in the treatment of acute complete dislocation of the acromioclavicular joint,leading to similarly good to excellent outcomes.However,triple button technique may be more advantageous in facilitating early functional recovery and pain-relieving of the shoulder. Key words: Acromioclavicular joint;  Shoulder dislocation;  Bone plates;  Comparative study