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Acromioclavicular joint dislocation treated with Bosworth screw and additional K-wiring: results after 7.8 years – still an adequate procedure?

Acromioclavicular joint dislocation treated with Bosworth screw and additional K-wiring: results after 7.8 years – still an adequate procedure?
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Tiefenboeck TM, Popp D, Boesmueller S, Payr S, Joestl J, Komjati M, Binder H, Schurz M, Ostermann RC,


Tiefenboeck TM, Popp D, Boesmueller S, Payr S, Joestl J, Komjati M, Binder H, Schurz M, Ostermann RC, (click to view)

Tiefenboeck TM, Popp D, Boesmueller S, Payr S, Joestl J, Komjati M, Binder H, Schurz M, Ostermann RC,

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BMC musculoskeletal disorders 2017 08 0418(1) 339 doi 10.1186/s12891-017-1692-0
Abstract
BACKGROUND
The acromioclavicular (AC) joint dislocation is a major reason for shoulder instability. Different concepts of treatment and surgical methods are described in the literature. Thus, the purpose of this study was to present our data of long-term follow-up of patients having undergone treatment of acromioclavicular (AC) joint dislocation using the Bosworth Screw with additional K-wiring.

METHODS
This study was conducted as a retrospective single centre data analysis. All patients treated operatively for AC joint dislocation with a Bosworth screw and additional K-wire fixation at our Department were asked to participate in this study.

RESULTS
The study population consisted of 22 patients, 20 male and 2 female, with a mean age of 40 years ±15.6 years. Three grade-II lesions, 13 grade-III lesions, four grade-IV lesions and two grade-V lesions according to the Rockwood classification were found. The overall mean clinical outcome at the latest follow up was: Constant 95, DASH 6.4, ASES 94.6, SST 99.02, UCLA 33.1, ACJI 91.82 and VAS 0.29 – representing a good-to-excellent long-term outcome in all patients after at least 2 years follow-up (range; 2 – 19 years). Overall, 19 patients (86%) reported to be very satisfied with the achieved result, 15 patients (68%) reported to be able to participate in every sports activity and 16 patients (73%) reported to be able to perform their daily work without limitations. Overall, complications occurred in three patients (14%). Only one patient remained unsatisfied with the achieved result.

CONCLUSION
Summarizing, our reported results showed that surgical fixation of acute AC joint dislocation with a Bosworth screw and additional K-wire fixation leads to good-to-excellent functional outcome and highly satisfactory results in the majority of patients. Despite its complications, in accordance with our results, Bosworth screw fixation with additional K-wiring in AC joint dislocation represents an adequate surgical procedure.

LEVEL OF EVIDENCE
Level IV, retrospective study.

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