Biomechanical Analysis of Different Operative Techniques for Complete Acromioclavicular Joint Disruptions

C. Fialka; W. Michlits; P. Stampfl; G. Oberleitner; P. Funovic; W. Schmidt; A. Aharinejad; V. Vécsei

doi:10.1055/s-2005-836559

Osteosynthesis and Trauma Care, Inhaltsverzeichnis

Osteosynthesis and Trauma Care 2005; 13(3): 154-159
DOI: 10.1055/s-2005-836559

Original Article

Biomechanical Analysis of Different Operative Techniques for Complete Acromioclavicular Joint Disruptions

C. Fialka¹ , W. Michlits¹ , P. Stampfl¹ , G. Oberleitner¹ , P. Funovic² , W. Schmidt³ , A. Aharinejad⁴ , V. Vécsei¹

¹Department of Traumatology, Medical University of Vienna, Austria
²Department of Orthopedics, Medical University of Vienna, Austria
³Department of Radiooncology, Danube Hospital, Vienna, Austria
⁴Department of Anatomy, Medical University of Vienna, Austria

Abstract

The goal of this study was to evaluate three different operative techniques for acromioclavicular joint fixation: trans-articular K-wire fixation; ligament reconstruction along with a synthetic augmentation device (LARS®); and coracoclavicular Bosworth screw. Mechanical properties were tested in a cadaver study in order to determine the primary mechanical stability during repetitive passive motion. Eighteen fresh cadavers were used to test a cyclic load (50 000 cycles). Secondary joint dislocation and the rate of implant loosening were monitored by standard AP stress X-ray. Metal markers in the coracoid, the acromion, and the lateral clavicle were used to measure the acromioclavicular distance increase (Δ-AC) and the coracoclavicular distance increase (Δ-CC). The range of motion was set on 30-90° of abduction for the first 25 000 cycles and then was raised to 60-120°. The least amount of vertical dislocation was seen in the K-wire and the LARS® group (mean Δ-CC 0.3 mm; range: 0-1.3 mm and 1.5 mm; range 0-6.7 mm, respectively). The Bosworth group showed significantly higher dislocation rates (4.2 mm; range 2.3-7.1 mm; p = 0.005). This was true especially when the abduction range was extended to a maximum of 120°. The rate of implant loosening in the K-wire group was higher than that in the other two groups. This study shows that the LARS® procedure and the K-wires technique give equal results concerning stability after repetitive passive motion, but with a high rate of implant loosening in the K-wire group. According to our findings, abduction should be limited to 90° after implanting a Bosworth screw in order to prevent loosening or failure of the hardware.

Key words

AC joint - biomechanics - anatomical study

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Referenzen

References

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C. FialkaM. D.

Department of Traumatology · Medical University of Vienna · General Hospital Vienna

Währinger Gürtel 18-20

1090 Vienna

Austria

Telefon: +43/4 04 00/59 59

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eMail: c.fialka@netway.at