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[Comparison of therapeutic effects of two internal fixations for the treatment of acromioclavicular joint dislocation of Allman Grade III].

OBJECTIVE
To compare therapeutic effects between Kirschner tension band fixation (TBF) and clavicular hook-plate (CHP) for treating acromioclavicular dislocations of Allman Grade III.


METHODS
From Jan. 1995 to Dec. 2007, a total of 39 patients who were diagnosed as acromioclavicular joint dislocation of Grade III were treated with Kirschner tension band fixation (TBF 18 patients, 12 patients were male, 6 patients were female, mean age were (27.50 +/- 12.76) years old, average fixation duration were (4.28 +/- 1.27) months) and clavicular hook plate fixation (CHP 21 patients, 18 patients were male, 3 patients were female, mean age were (34.76 +/- 12.39) years old, average fixation during were (8.29 +/- 1.49) months). All the patients were followed up with a mean period over 4 years. The therapeutic effects of the two groups were compared base on complications, Karlsson scores and re-subluxation.


RESULTS
The average period from injury to fixation removal was (4.28 +/- 1.27) and (8.29 +/- 1.49) months in TBF and CHP groups respectively, comparison between the two groups, t = -8.951, P < 0.01, there was statistical difference, and the course of disease in TBF group was shorter than that of CHP group. Five patients in TBF group and 1 patient in CHP group had complications (P = 0.077 > 0.05), as well as 3 patients in TBF group and 1 patient in CHP group had re-subluxation (P = 0.318 > 0.05). Karlsson evaluation results:in TBF group, 15 patients got a grade A result, 3 grade B and 0 grade C; and in CHP groups above data was 20, 1 and 0 respectively (P = 0.530 > 0.05). There was no statistical differences between the two groups in evaluation outcomes.


CONCLUSION
The two fixation methods are all effective methods to treat Grade III acromioclavicular dislocation of Grade III, and the long-term outcome is satisfactory.