Treatment of type III Acromioclavicular dislocation with open reduction and percutaneous K-wire fixation

Author(s): Reda H ElKady and Nagy Fuda

Abstract: Background: The direct force acting on the shoulder from the lateral side with the arm in an adducted position is the main mechanism of injury in the vast majority of traumatic dislocations of the acromioclavicular joint.
Patients and method: Fourteen patients with an acromioclavicular separation (Rockwood type III) were surgically treated with open reduction, repair of the capsule, and percutaneous 2 K-wires fixation under image intensifier. There were 10 men and 4 women with a mean age of 37 years from 23 to 60). The surgery was done 10.2 days average after trauma (range 3–21 days).
Results: The follow-up period ranged from 8 months to 30 months (Average 18 m). According to Constant score seven patients had excellent score, five good, two fair, and no poor results were obtained. Complications were two migrated K-wires five weeks postoperative were removed without influence on the final result. Superficial wound infections occurred in three cases and needed no further surgical treatment, only dressing and oral antibiotic for two weeks. Shoulder stiffness was mild in two cases and did not impair in the patient daily activities. We had no deep infections or nerve palsies.
Conclusion: Open reduction, repair of the capsule, and percutaneous transfixing 2 K-wires is a valid and good method for treatment of type III Rockwood type acromioclavicular dislocation with little rate of subluxation, joint stiffness, or ligament ossification.

DOI: https://doi.org/10.22271/ortho.2017.v3.i4d.35