Arthroscopic Treatment of Chronic Acromioclavicular Dislocation With Semitendinosus Autograft and Coracoclavicular Suspension Fixation.

The management of acromioclavicular dislocations remains controversial. On many occasions, these chronic dislocations are asymptomatic. However, there are patients who, despite good rehabilitation treatment, do present with pain, periscapular muscle fatigue, weakness, paresthesia or scapular dyskinesia. In these patients, surgical treatment is indicated.

Fixation of olecranon osteotomy only with 6'5 mm partially trheaded cancellous screw is a safe an effective method used in surgical management of distal humerus fractures.

PURPOSE: The objective of this study is to demonstrate the safety and efficacy of the osteosynthesis with a 6.5 mm screw and washer of a Chevron shape olecranon osteotomy performed for the surgical approach of supraintercondylar fractures of the distal humerus, achieving union and complication rates better or similar to other published case series. METHODS: From 2009 to 2019, 26 patients underwent fixation of an olecranon osteotomy for the treatment of a supraintercondylar fracture of the distal humerus with partially threaded cancellous cannulated screws of 6.5 mm diameter with a washer. The patients were followed for at least 1 year, taking radiographs the day after the surgery, at 3, 6 and 12 months. Complications have been collected: infection, loss of reduction, non-union, delay of union, discomfort of the osteosynthesis hardware. The diameter of the ulna medullary canal diaphysis was also measured in all patients. RESULTS: Consolidation of the osteotomy was 100% at 12 months. The average time of radiological consolidation was 112 ± 12 days. The average size of the ulna medullary canal diaphysis was 6'06 ± 0'16 mm on anteroposterior radiographs and 5'65 ± 0'14 mm on lateral radiographs. The mean screw length was 102'31 mm ± 3'89. We found 1 acute infection, 2 osteotomies delays of union (one of these cases was the acute infection case), one early osteosynthesis failure and 1 wound dehiscence. CONCLUSIONS: Olecranon ostetomy fixation with a 6'5 mm cancelous partial threaded screw and washer is safe and effective with a high consolidation rate and excellent results and with complication rates similar to or lower than other fixation methods published. Long enough screws must be used to get a good cortical grip with enough stability. LEVEL OF EVIDENCE: Level IV, Case series, retrospective review.