Combined Intra-articular K-wire and Coracoclavicular Screw Fixation for Type III Acromioclavicular Joint Dislocations- A Randomized Controlled Study with Minimum of 3 Years Follow-up

Abstract

BACKGROUND: Treatment of Rockwood type III acromioclavicular dislocations is still controversial with evidence present in favour of both operative and non-operative interventions.

MATERIAL AND METHODS: A prospective randomized controlled clinical trial was conducted at the Department of Orthopaedics of a Level I trauma centre including 54 (male = 34, female = 20) cases of type III acromioclavicular dislocations, randomized into two groups A (operative) and B (non-operative). Group A cases underwent surgery using combined intra-articular K-wire and coracoclavicular screw fixation. Group B cases were treated non-operatively using arm sling and rest.

RESULTS: Mean follow-up period was 40.8 months (range = 36-49). Mean Constant Shoulder scores for group A and B were 93 and 83.5 after 12 months (p value ≤ 0.0001); 93.3 and 86.5 after 36 months (p value ≤ 0.0001), respectively. Complications reported from group A were hardware failure, heterotopic ossification, distal clavicle osteolysis and superficial stich infection and from group B were cosmetic deformity and intermittent pain around shoulder.

CONCLUSIONS: In this study, operatively managed cases did significantly better than the non-operatively treated ones with faster and improved functional outcomes.