Percutaneous minimally invasive repair of acromioclavicular joint dislocation using cannulated screws under ultrasonic vs. C-arm navigation: A prospective trial.

INTRODUCTION: To compare percutaneous minimally invasive repair (PMIR) of acute acromioclavicular (AC) joint dislocation under ultrasound guidance (PMIR-UN) vs. C-arm navigation (PMIR-CN).

HYPOTHESIS: PMIR-UN has similar functional and radiographic outcomes as PMIR-CN.

MATERIALS AND METHODS: We treated 48 patients with acute grade III or V AC joint dislocation with surgical reduction and fixation with Kirschner wires and cannulated screws. The patients were randomly divided into a PMIR-UN group (n=24) and a PMIR-CN group (n=24). We assessed functional outcomes, operative duration, incision length, and intraoperative radiation exposure. Shoulder joint function was evaluated with the Constant-Murley score, and postoperative efficacy was evaluated using the Karlsson criteria.

RESULTS: The median follow-up duration was 13 months (range, 8-18 months). Satisfactory functional outcomes were obtained in both groups. Incision length, incidence of postoperative infection, pin migration, and postoperative efficacy did not differ between the two groups. Operative duration and intraoperative radiation dose were significantly greater in the PMIR-CN group than in the PMIR-UN group (P<0.05). Kirschner wires were removed at 4 weeks after surgery, and cannulated screws were removed at 12 weeks after surgery in both groups.

DISCUSSION: Based on the satisfactory results obtained in all patients, we conclude that PMIR-UN is a safe, easy, and reliable technique for the treatment of acute grade III or V AC joint dislocation.

TYPE OF STUDY: Low-powered prospective randomized trial.

LEVEL OF EVIDENCE: Level II.