Surgical Treatment of Patients with Dislocations of the Acromial End of the Clavicle

Treatment results of 404 patients with dislocations and fracture-dislocations of the acromial end of the clavicle were analyzed. Depending on the severity and remoteness of ligamentous system injury the most rational methods for clavicle fixation using devices with shape memory effect were determined. In 158 (39.1%) patients with II degree of clavicle dislocation by Tossy transarticular fixation using devices with shape memory effect was performed. In 177 (43.8%) cases clavicular-coracoid fixator was used to stabilize the clavicle in sagittal plane. In 54 (13.4%) patients with old clavicular dislocations of II-III degree and in repeated interventions combined fixation by S-shaped clip with protective leg and clavicular-coracoid device was performed. Treatment results were assessed at terms 1 - 8 years. In patients with fresh clavicular acromial end dislocations of II degree the effective treatment method was the reconstruction of ligamentous system in combination with transarticular fixation of the clavicle by S-shaped tightening clip (89.7% of good results). In repeated interventions and clavicular acromial end dislocations of III degree the fixation with clavicular-coracoid device and combined fixation without plasty of the ligaments gave good results in 79.1% of cases.