Palmaris longus tendon versus iliotibial tract fascia graft for coracoclavicular ligament reconstruction combined with hook plate fixation in treatment of acromioclavicular joint dislocation / 中华创伤骨科杂志

ABSTRACT

Objective To compare the clinical outcomes of palmaris longus tendon (PLT) and iliotibial tract fascia graft (ITFG) for coracoclavicular ligament (CCL) reconstruction combined with hook plate fixation in the treatment of acromioclavicular joint (ACJ) dislocation.Methods A retrospective study was conducted to evaluate the outcomes of 68 patients with ACJ dislocation of Rockwood type Ⅲ and above who had been treated in our department with CCL reconstruction using PLT or ITFG in addition to hook plate fixation from January 2008 to January 2014.They were 57 males and 11 females,with an average age of 36.1 years (range,from 19 to 55 years).The patients were divided into 2 groups according to their grafts used in CCL reconstruction36 cases in PLT group and 32 in ITFG group.They were firstly treated with CCL reconstruction followed by hook plate fixation.The hook plates were removed at 6 months after operation.The acromioclavicular and coracoclavicular distances were measured on the postoperative anteroposterior radiographs of the injured shoulders.The outcomes were assessed at the final follow-ups according to Constant-Murley shoulder score and Karlsson criteria.The 2 groups were compatible without significant differences in preoperative general data (P ＞ 0.05).Results The 68 patients were followed up for an average of 18 months (range,from 16 to 22 months).The acromioclavicular and coracoclavicular distances measured in PLT group at 12 months after operation were significantly larger than those measured in ITFG group (P ＜ 0.05).At the final follow-ups,the Constant-Murley shoulder score (92.1 ±7.2) and Karlsson excellent to good rate (83.3％,30/36) in ITFG group were insignificantly higher than those in TIR group (88.3 ± 9.8;81.3％,26/32) (P ＞ 0.05).Conclusion In the treatment of ACJ dislocation of Rookwood type Ⅲ and above,CCL reconstruction using ITFG may lead to better radiographic outcomes than that using PLT,though the 2 grafts lead to similar functional recovery of the injured shoulders.