Internal splintage of acute acromioclavicular joint dislocation using polyester suture: Experience from a Nigerian orthopaedic hospital.

BACKGROUND: Various surgical options have been described for acute acromioclavicular joint (ACJ) disruption. Dynamic fixation of these fractures is the most favoured option. However, no single modality of treatment has been adjudged to be the best option so far. PURPOSE: The goal of this study was to present the outcome of internal splintage of acute ACJ disruption using polyester suture without clavicle drilling in our setting. PATIENTS AND METHODS: This prospective study was done at the National Orthopedic Hospital, Dala, Kano, on those with acute ACJ injuries between January 2016 and June 2021. Forty five patients (36 males and 9 females) had internal splintage of acute ACJ disruption using polyester-5 suture loops around the coracoid process and clavicle without bone drilling. RESULTS: The average age of the patients in this study was 31.51 ± 11.43 years, while the age group with highest frequency was 21-30 years, accounting for 17 (37.8%) of all the patients. The mean pre-operative and post-operative disability (QuickDASH) scores were 80.08 ± 10.75 and 3.23 ± 3.58, respectively. There was a significant difference between pre-operative and post-operative QuickDASH scores with P < 0.001. CONCLUSION: Internal splintage of acute ACJ dislocation using polyester-5 suture loop without bone drilling is effective and safe.

Arthroscopic Procedure for Chronic Isolated Bucket-Handle Meniscal Tears.

Arthroscopic treatment is the treatment of choice in bucket-handle meniscal tears (BHMTs). Following BHMT, however, surgery failure rates are approximately 20% in the literature. Achieving the healing of BHMT is difficult. This is worse in chronic situations because the torn meniscus is deformed, leading to nonanatomical reduction. Some authors have reported greater failure rates, especially in the early postoperative period. In isolated BHMTs, the failure rate is greater because of inadequate and incomplete repairs due to the tight medial compartment. Multiple techniques for possible reduction of failure rate have been described. We describe an arthroscopic technique for treating chronic isolated BHMT using the technique of subcutaneously releasing the posterior fibers of the medial collateral ligament to provide adequate space for arthroscopy, meniscal reduction, and repair. A combined inside-out and all-inside repair technique was used to enhance anatomic reduction, stable fixation, surface fixation (rather than the usual suture-points fixation), and biologic healing in repairable chronic BHMTs.