Traitement percutané mini-invasif des luxations acromion-claviculaires par vis canulée sous contrôle échographique versus amplificateur de brillance. Une étude prospective - 10/01/18

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

Doi : 10.1016/j.rcot.2017.12.026

X. Shui ^a, S. Chen ^b, G. Huang ^a, J. Kong ^a, C. Zhou ^a,^⁎ , W. Lin ^a,^⁎
^a Department of Orthopedics, The Second Affiliated Hospital of Wenzhou Medical University, No. 1838 Xueyuan West Road, Wenzhou 325027, Zhejiang, China
^b Department of Orthopedic rehabilitation, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China

^⁎Auteurs correspondants.

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Wednesday 10 January 2018
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Abstract

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.

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Keywords : Acromioclavicular joint dislocation, Internal fixation, Minimally invasive, Radiation dose, Ultrasonic navigation

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