THE RESULTS OF CORACO-CLAVICULAR SLINGS FOR ACROMIOCLAVICULAR DISLOCATION

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.