[Comparative analysis of modified Dewar method versus arthroscopic double Endobutton fixation technique for the treatment of acute acromioclavicular joint dislocation].

Objective: To compare the clinical outcomes of modified Dewar method versus arthroscopic double Endobutton fixation technique for the treatment of acute acromioclavicular joint dislocation (Rockwood types III-V).

Methods: All cases with acute acromioclavicular joint dislocation (Rockwood types III-V) were treated at our department from October 1997 to October 2009. Among them, 28 cases undergoing modified Dewar method were followed up. There were 20 males and 8 females aged 18 - 68 years old with a mean follow-up period of 6.8 years. And the arthroscopic technique of Endobutton fixation was employed for another 24 cases. There were 19 males and 5 females aged 19 - 65 years old with a mean follow-up period of 1.5 years. The radiographic findings, clinical outcomes and complications of two groups were compared.

Results: The good/excellent rate of modified Dewar group and arthroscopic double Endobutton group were 92.8% and 95.8% respectively. There was no significant difference between two groups. No significant difference existed between two groups as to the VAS (visual analogue scale) pain score and UCLA (University of California at Los Angeles) score. The modified Dewar group had a higher rate of ectopic ossification in coracoclavicular ligament than that of the arthroscopic double Endobutton group (25% vs 8.33%). Yet there was no statistical significance. However, the distance between clavicle and coracoid process was larger in the modified Dewar group (11.96 vs 8.54 mm, P < 0.05).

Conclusion: Both modified Dewar method and arthroscopic double Endobutton fixation technique are both efficient therapies for acute acromioclavicular dislocation (Rockwood types III-V). The former tends to be more invasive while the latter can better maintain the relationship of coracoid process and clavicle.