Central K-wire and PDS-cord for acromioclavicular separations - a successful treatment?

Beside the basic question wether a separation of the acromioclavicular join t should be treated operatively or not, the method of operation is discusse d in particular. For that reason we investigated our own method of a tempor ary transfixation of the joint by a centrally drilled K-wire combined with a PDS-augmentation of the coracoclavicular and a suture of the acromioclavi cular ligament. Follow up examinations were possible in 57 out of 82 patien ts which were operated during 5 years. Patients subjective rating and objec tive follow up and sonographically evaluated joint conditions were scored t ogether. Looking for the range of motion of the soulder only 5.5% of the pa tients had a reduction of more than 20 degrees. Out of 12 complications in particular three infections only resulted satisfying by influencing the sub jective rating negatively. In 28.1% of patients no durable anatomic reconst ruction of the joint was achieved. Score achieved by these patients was sig nificantly lower compared to those with a lasting anatomic reconstruction o f the acromioclavicular joint. In conclusion the results confirm our operat ive regime for separations of the acromioclavicular joint. In literature su rvey the here described method of operation belongs to the better ones with out showing a clear advantage. Nevertheless the method should be modified t o decrease the rate of subluxations.