Department of Orthopedics and Traumatology, Erzincan University Faculty of Medicine, Erzincan-Turkey.
Department of Orthopedics and Traumatology, MS Baltalimanı Bone and Joint Diseases Training and Research Hospital, İstanbul-Turkey.
Ulus Travma Acil Cerrahi Derg. 2022 Jun;28(6):839-848. doi: 10.14744/tjtes.2021.45985.
The aim of this study is to compare open double-button (DB) and hook plate (HP) techniques in the treatment of acromioclavicular joint dislocation (ACJD) in terms of clinical and radiological outcomes and to determine which method is superior.
This retrospective comparative study included patients with ACJDs (Rockwood Type III/V) who were treated with one of these implants (22 patients with HP, 21 patients with DB) between June 2014 and February 2018.
A total of 43 patients (39 men and 4 women) with a mean age of 41.8±17.4 years have participated in this study. The mean follow-up time was 20.6±7.5 months. Mean times of fluoroscopy, operation, and return to work were shorter in the DB group. Compli-cation rates were 23.8% and 54.6%, reoperation rates (including mandatory implant removals [IR]) were 4.8% and 77.3%, mean constant scores were 92.1±3.4 and 88.3±4.2, and mean Visual Analog Scale scores were 0.8±1.0 and 1.5±1.0 for the DB and HP groups, respec-tively. IR was the main reason for reoperations in the HP group, whereas the DB group's only reoperation was caused by a coracoid cutout (due to coracoid tunnel malposition) leading to redislocation. AC joint arthritis (36.4%) and subacromial osteolysis (31.9%) were com-monly encountered in the HP group. The most frequent complication of the DB group was malreduction (initial undercorrection) (9.6%).
DB was superior to HP in functional outcome, post-operative pain, complication and reoperation rates, operation and fluoroscopy times, and time to return to work. Besides, reoperation (for IR) was needed in most of the HP patients. Therefore, the open DB technique should be preferential to the HP procedure.
本研究旨在比较开放式双按钮（DB）和钩板（HP）技术在治疗肩锁关节脱位（ACJD）方面的临床和影像学结果，并确定哪种方法更优。
本回顾性对照研究纳入了 2014 年 6 月至 2018 年 2 月期间采用这些植入物治疗的 ACJD（Rockwood Ⅲ/Ⅴ型）患者（HP 组 22 例，DB 组 21 例）。
共有 43 名患者（39 名男性和 4 名女性）参与了这项研究，平均年龄为 41.8±17.4 岁，平均随访时间为 20.6±7.5 个月。DB 组的透视和手术时间以及重返工作岗位的时间均较短。DB 组的并发症发生率为 23.8%，HP 组为 54.6%；DB 组的再手术率（包括强制性植入物取出[IR]）为 4.8%，HP 组为 77.3%；DB 组的 Constant 评分平均为 92.1±3.4，HP 组为 88.3±4.2；DB 组的视觉模拟评分平均为 0.8±1.0，HP 组为 1.5±1.0。HP 组再手术的主要原因是 IR，而 DB 组唯一的再手术是由于喙突切出（由于喙突隧道位置不当）导致再脱位。AC 关节关节炎（36.4%）和肩峰下骨溶解（31.9%）在 HP 组中较为常见。DB 组最常见的并发症是复位不良（初始矫正不足）（9.6%）。
与 HP 相比，DB 在功能结果、术后疼痛、并发症和再手术率、手术和透视时间以及重返工作时间方面具有优势。此外，大多数 HP 患者需要再次手术（IR）。因此，开放式 DB 技术应优先于 HP 术式。
