M. Clayer et al., THE RESULTS OF CORACO-CLAVICULAR SLINGS FOR ACROMIOCLAVICULAR DISLOCATION, Australian and New Zealand journal of surgery, 67(6), 1997, pp. 343-346
Background: Treatment of type 3 acromio-clavicular (A-C) dislocations
is controversial. There have been over 60 different surgical procedure
s as well as a variety of conservative measures used to treat this inj
ury. Methods: The outcome of a coraco-clavicular (C-C) sling for grade
3-4 A-C dislocation was studied. A dissolvable sling of braided 1 pol
ydioxanone (PDS, Ethicon) was used with or without excision of the dis
tal end of the clavicle in six patients. The clinical and radiological
outcome of the braid and acromio-clavicular joint were studied by cli
nical examination, plain and stress radiographs and magnetic resonance
imaging (MRI). Results: All patients reported good-excellent results
from 6 months after surgery. Radiological examination demonstrated som
e superior clavicular migration in all patients within 1 month of the
procedure, although never more than that seen with a grade 2 dislocati
on. This migration was clinically evident only in patients with a thin
build. At 1 month, the MRI demonstrated partial replacement of the br
aid by granulation tissue. From 6 months on, the braid was absent and
fibrous tissue was noted between the coracoid and the clavicle and the
acromion and clavicle. Conclusions: The coraco-clavicular sling did n
ot maintain operative reduction of the dislocated clavicle. This did n
ot diminish the functional result but was a cosmetic complication in p
atients with a thin build.