Double Button Fixation System for Reconstruction of Coracoclavicular Ligament Disruption

Abstract

Background and aim: Coracoclavicular (CC) ligament disruption is a common orthopedic injury. Many treatment techniques are available and others continue to emerge. However, none of them was considered as the gold standard technique. The current work aimed to evaluate the mid-term results of open surgical fixation of the acute CC ligament disruption by a double-button fixation system.

Patients and Methods: This was a prospective clinical study, including 80 adult patients with CC ligament disruption. All were subjected to clinical, radiological and laboratory evaluation. Then, under general anesthesia, a double-button fixation was performed. All were assessed for postoperative complications, functional outcome (by Constant score, The American shoulder and elbow surgeons standard shoulder assessment form (ASES) score, the disability of the arm, shoulder and hand (DASH) score and visual analogue scale (VAS) score.  The final follow-up visit was set at the end of the 6^th month after surgery.

Results: The commonest mode of trauma was road traffic accident (55.0%). The left was affected more than the right side (65.0% vs 35.0%). Complications rate was 20.0%. The constant and ASES score significantly increased postoperatively than corresponding preoperative values (95.2±4.7, 97.22±4.8 vs 34.0±5.5 and 39.34±4.34 respectively). Otherwise, the DASH score was reduced from 16 before to 6 after surgery. Finally, DASH score was only significantly associated with mode of trauma.

Conclusion: The double-button fixation system does minimal damage to the soft tissues surrounding the ligaments and is an effective, suitable and safe technique for the management of acute coracoclavicular ligament disruption.