Modified Weaver-Dunn Technique in Management of Acromio-clavicular Joint Dislocation
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- Category: Vol. 84, September 2016
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Modified Weaver-Dunn Technique in Management of Acromio-clavicular Joint Dislocation, HANY MOHAMMADY, ASHRAF N. MOHARRAM, WALEED REDA, HAZEM MAHMOUD and AHMAD ABUELFADL
Abstract
Background: The treatment of AC dislocation is based upon the classification scheme, Type I and II injuries can be treated symptomatically, The treatment of type III injuries remains somewhat controversial, While operative intervention is often reserved for types IV, V and VI. Although there are more than 60 surgical techniques reported for repair and reconstruction of Acromio-clavicular and Coraco-clavicular ligaments, no gold standard exists.
Methods: This is a prospective study was conducted on 23 patients suffering from chronic AC dislocation presented to Kasr Al-Ainy Hospital from June 2011 till December 2013, treated by Modified Weaver-Dunn technique with mean age of 38.9 years and mean follow-up duration was 10.05 month. 2 patients were excluded due to associated rotator cuff tear and one patient was lost in follow-up. So our statistics were based on 20 patients. This procedure involves the release of the Coracoacromial ligament from the acromion and its transfer with a bone block to the clavicle after resection of its distal end (1cm), and coracoclavicular sling augmentation with various types of non-absorbable materials as Dacron and mersilene tape.
Results: 20 patients with chronic AC joint dislocations were included in this study, all patients were evaluated pre and postoperative with Constant score and American Shoulder Elbow Score and accordingly we evaluated the patients after two weeks, one month, 3 month, 6 month and 12 month, with a mean of 10.05 month follow-up, American Shoulder Elbow Score; there was significant improvement from an average score of 38.15 (SD =5.02) preoperatively out of 100 points to an average score of 70.35 (SD=4.53) 3 month postopera-tively and mean score of 91 (SD=6.05) on the last follow-up.
Conclusion: Results were excellent in 75% of the patients, good in 15%, fair in 5% and poor in 5%. The average Constant pain score improved postoperatively for all patients, and the scores for function, strength, and flexion improved for all patients. Our experience thus far with this technique is en-couraging for patients with chronic ACJ dislocation type (III, IV, V & VI) with good radiographic evidence of ACJ reduction post operatively and patient satisfaction and early return to normal activity.
Level of Evidence: Level IV case series study.