Treatment Of Acromioclavicular Dislocation And Distal Clavicular Fracture With The Multifunctional Acromioclavicular Fixing Band

Background and objectiveThe injury of acromioclavicular dislocation or distal clavicular fracture is very common.The Rockwood classification system for the injury is well accepted now.But there is still no a consensus of opinion now about the therapy choice for different injuries within surgeons.Controversies mainly focus on the therapy of third-degree acromioclavicular dislocation and second-degree distal clavicular fracture according to Rockwood's classification.Both operative and non-operative treatment is reported to have satisfactory results in the literature.Regarding there is no efficient external fixation appliance now,most doctors prefer to choose operating therapy for these patients.The purpose of this study was mainly to analyze prospectively the effect of different operating methods for acromioclavicular dislocation and distal clavicular fracture in our hospital and other branch centers,to determine the best method for different injuries.The purpose of this study was mainly to analyze the clinical effect and security of the treatment of acromioclavicular dislocation and distal clavicular fracture with the multifunctional acromioclavicular fixing band.To make sure the treatment method is efficient and safe,also we tried to quantitate the pressure the fixing band needed through experiment research.At last,we would define the indication for applying of the product and formulate the standard process for operating clinically.Further more,the product will be developed according to the clinical effect.We attempt to provide another therapy choice besides surgery for those patients with acromioclavicular dislocation or distal clavicular fracture.MethodsThe clinical trial method prospectively was applied in the study,and also we did much experiment resarch about the acromioclavicular fixing band.We determined the pressure the fixing band needed through experiment research designed by ourself,to make sure the treatment method is efficient and safe.What is more important,this experiment can provide a training method for using the external fixing band normatively.In the clinical study of this external fixation,36 patients with acromioclavicular dislocation(Rockwoodâ… -â…¢)or distal clavicular fracture(Rockwoodâ… -â…¢)were adopted.All the patients were treated with the multifunctional acromioclavicular fixing band immediately after the injury was reducted manually.Subsequently,patients would keep the external fixation for 4-6 weeks.And we would give patients the guidance for rehabilitation exercise during this time.All patients were asked to recheck once in a week at least.We would make a careful check and adjust the fixing band if necessary,to avoid the complication such as the skin sore or neurovascular damage.The external fixation was removed after 4-6 weeks.Patients should continue to keep rehabilitation exercise,In this stage,the condition of patients was better and stable,so it is unnecessary to recheck frequently.We asked the patients to recheck once in a month.All the patients were followed up for 6-9 months in all.Detailed condition of patients should be recorded for every rechecking,including the incidence rate of complications.The evaluation of treatment effect were maked at 3 and 6 months after the treatment for every patient,including the function of shoulder joint and upper limb,pain score according to the VAS,appearance of shoulder,appearance of X-ray etc.After analysis statistically,we could obtain the data of effective power,Indication for applying of the product were defined according to the treatment effct for injuries of different degrees.And the standard process for operating clinically were formulated.All the time during the study,we had been trying to develop the design of the product in time according to the backing off from clinical use.ResultWe designed an experiment plan ourself and determined the pressure the fixing band needed.What is more important,this experiment provided a training method for using the external fixing band normatively,In clinical resarch,all the patients were followed up for 6-9 months,averaged 7.2 months.The clinical effect was satisfactory according to the JOA score,VAS score,etc.28 patients were excellent,6 patients were well.One patient leaded to periarthritis of shoulder because of negative rehabilitation exercise,and all other patients returned to the pre-injury level of activity with no residual pain or dysfunction.The complication of skin sore occurred in a acromioclavicular dislocation patient(â…¢degree),but it is not serious and healed quickly after treatment,and there was no neurovascular damage.The product was designed advancedly in some aspects,mainly to develop the disadvantage of lack of strength for suspending the upper limb.ConclusionIt is a simple,efficient and safe conservative therapy for acromioclavicular dislocation(Rockwoodâ… -â…¢)and distal clavicular fracture(Rockwoodâ… -â…¢)with the multifunctional acromioclavicular fixing band.On the other hand,the case sample of this study is not big enough,so further study of the treatment effect is necessary,especially for third-degree acromioclavicular dislocation and second-degree distal clavicular fracture.