Comparison Of Three Surgical Methods For The Treatment Of Acromioclavicular Dislocation: Clavicular Hook Plate,endobutton Single Beam And Double Beam Repair Of Coracloclavicular Ligament

ObjectiveTo compare the therapeutic effects of conventional hook plate operation,doublebeam repair operation of ligament coracolaviculare including ligamenta trapezoideum and conical ligament,as well as three-beam repair operation of ligament coracolaviculare and coracoacromial ligament.MethodsTo analyze the characteristics of 62 patients,who suffering Tossy III acromioclavicular jointdislocation and received operation in our hospital from FebruaryDecember 2015 to FebruaryDecember 2018.All patients were divided into three groups according to their different operation.There were 29 patients in group A,who received conventional hook plate operation.There were 21 patients in group B,who received double-beam repair operation of ligament coracolaviculare including ligamenta trapezoideum and conical ligament.There were 12 patients in group C,who received three-beam repair operation of ligament coracolaviculare and coracoacromial ligament.Operation time,blood loss during operation,the length of operative incision as well as postoperative complications was compared.Constant-Murley score before and after operation one week,one month,three months,six months,12 months were evaluated.Karlsson criterion score after operation one week,one month,three months,six months,twelve months were evaluated.ResultsThere is significant difference for operation time between the three groups based on One-Way ANOVA analysis.The operation time of A group was shorter than the other two groups,while no significant difference was showed between B and C group(P>0.05).Significant difference was showed for amount of bleeding between the three groups based on One-Way ANOVA analysis.The bleeding amount of B group was less than the other two groups,which showed significant difference(P<0.05).There is significant difference for length of incision between the three groups based on One-Way ANOVA analysis.The incision length of A group was longer than the other two groups,while no significant difference was showed between B and C group(P>0.05).Significant difference was showed for postoperative complications between the three groups based on chi-square test.The postoperative complications of C group was less than the other two groups,which showed significant difference(P<0.05).Based on variance analysis of repeated measurements,there is no significant difference for Constant-Murley score before operation between the three groups(P>0.05).However,significant difference was showed for Constant-Murley score after operation one week between the three groups,while the score of B group was the highest than the other two groups(P<0.05).There is significant difference for ConstantMurley score after operation one month between the three groups,while the score of C group was the highest than the other two groups(P<0.05).No significant difference was showed for Constant-Murley score after operation three,six,twelve months between the three groups based on One-Way ANOVA analysis(P>0.05).The distinguished achiever ratio of C group was the highest after operation one week between three groups on the basis of Karlsson criterion analysis.The distinguished achiever ratio of B and C groups was the highest after operation one as well as three months between three groups on the basis of Karlsson criterion analysis.The distinguished achiever ratio of C group was the highest after operation six months between three groups on the basis of Karlsson criterion analysis.The distinguished achiever ratio of B and C groups was the highest after operation twelve months between three groups on the basis of Karlsson criterion analysis.ConclusionCompared with conventional hook plate,there is several advantages including shorter operation time,less amount of bleeding,narrower length of incision,less postoperative complications as well as shorter recovery time for double-beam repair operation of ligament coracolaviculare including ligamenta trapezoideum and conical ligament,as well as three-beam repair operation of ligament coracolaviculare and coracoacromial ligament.Therefore,it is more available for acromioclavicular joints patients of double-beam repair operation of ligament coracolaviculare including ligamenta trapezoideum and conical ligament,as well as three-beam repair operation of ligament coracolaviculare and coracoacromial ligament.