Coracoclavicular ligament repair and screw fixation in acromioclavicular dislocations

Objectives: We evaluated the long-term results of acromioclavicular dislocations treated with coracoclavicular fixation using a cancellous screw. Methods: Coracoclavicular fixation was performed using the modified Bosworth technique in 32 patients (24 males, 8 females; mean age 35 years; range 19 to 58 years) with acromioclavicular dislocations. According to the Rockwood classification, seven patients had type III, nine patients had type IV, 13 patients had type V, and three patients had type VI dislocations. Following repair of the coracoclavicular ligament, fixation was performed with a cancellous screw in all but two patients in whom a cortical screw was used. These two patients developed redislocation due to screw cut out and underwent reoperation with cancellous screw fixation and were not included in the final assessments. The screws were removed under local anesthesia after eight weeks postop- eratively. The patients were evaluated for cosmetic appearance, functional status, pain, localized tenderness, articular range of motion, and with the functional Constant scoring system. The mean follow up was 3.1 years (range 1 to 8 years). Results: The mean Constant score was 98 (range 92 to 100). The results were excellent in 26 patients (86.7%) and good in four patients (13.3%). There was subluxation of the acromioclavicu¬lar joint in one patient (3.3%). The alignment of the acromioclavicular joint was normal in the remaining patients. None of the patients showed joint degeneration. All patients were pain-free and achieved full range of motion. Conclusion: With ease of application, low complication rate, and low rate of acromioclavicular joint arthrosis, the modified Bosworth technique is an effective surgical method in providing satisfactory shoulder function in acromioclavicular dislocations.