Alisara Arirachakaran 1, Manusak Boonard 2, Peerapong Piyapittayanun 1, Wichan Kanchanatawan 3, Kornkit Chaijenkij 4, Akom Prommahachai 5, Jatupon Kongtharvonskul 6
- PMID: 28236179
- PMCID: PMC5685975
- DOI: 10.1007/s10195-017-0451-1
Free PMC article
Abstract
Background: Treatment of acute (≤3 weeks) acromioclavicular joint dislocation type III-VI is still controversial. Currently, the two modern techniques that are widely used are hook plate (HP) fixation and coracoclavicular ligament fixation using a suspensory loop device that consists of either a tightrope (single or double), endo-button (single or double), or synthetic ligament and absorbable polydioxansulfate sling.
Materials and methods: This systematic review was conducted according to the PRISMA guidelines. Relevant studies that reported Constant-Murley score (CMS), Pain Visual Analog score (VAS) and postoperative complications of either technique were identified from Medline and Scopus from inception to 5 October 2015.
Results: Sixteen studies were included for the analysis of HP fixation, and 25 studies were included for analysis of loop suspensory fixation (LSF). Pooling of mean CMS and VAS scores gave 90.35 (95% CI 87.16, 93.54), 1.51 (95% CI 0.73, 2) in the HP group, and 92.48 (95% CI 90.91, 94.05), 0.32 (95% CI 0, 0.64) in the suspensory loop devices group, respectively. The pooled unstandardized mean differences (UMD) scores of CMS and VAS in LSF were 2.13 (95% CI -1.43, 5.69) and -1.19 (95% CI -2.03, -0.35) when compared to hook plating. The pooled prevalence of LSF and hook plating were 0.08 (95% CI 0.06, 0.10) and 0.05 (95% CI 0.02, 0.08) scores. The chance of having complications in the LSF group was 1.69 (95% CI 1.07, 2.60), which was statistically significantly higher than in the HP group.
Conclusion: LSF have higher shoulder function scores (CMS) and lower postoperative pain when compared to HP fixation; however, there are higher complication rates with LSF when compared to hook plating.
Level of evidence: IV.
Keywords: AC injury; Endobutton; Hook plate; Loop suspensory fixation; Systematic review; Tightrope.
Conflict of interest statement
Conflict of interest
All authors declare that they have no conflicts of interests.
Patient consent
For this type of study informed consent is not required.
Ethical approval
Not applicable as no new patients were involved in this research.
Funding
None.
