Acute complete acromioclavicular dislocation. A prospective randomized trial of fixation with smooth or threaded Kirschner wires or cortical screw.

During 1983-1984, 86 patients with complete dislocation of the acromioclavicular joint verified also by stress radiographs were operated on and followed-up for at least one year. In transfixation two smooth Kirschner wires, two threaded Kirschner wires or one cortical screw were used. The acromioclavicular ligament was sutured and the damaged disk removed, but the coracoclavicular ligament was left unsutured. At the one-year follow-up, the results were good in 82 patients according to the classification of Darrow et al. Radiologically, the acromioclavicular joint was in place in 67 patients. Partial dislocation was observed in 14 patients and complete dislocation in 5 patients. Clinical results were not related to the type of treatment. The only statistically significant difference was osteolysis of the lateral head of the clavicle; eight of the 13 cases of osteolysis were due to screw fixation (p less than 0.001).