Double Beam Ligament Transfer In The Treatment Of RockwoodⅢ Acromioclavicular Joint Dislocation: Anatomical And Clinical Analysis

Objective:To use conjoined tendon and coracoacromial ligament transfer for c-oracoclavicular ligament reconstruction in the repair of RockwoodⅢ acromioclavicu-lar joint dislocation, to provide the theoretical foundation through the autopsy, and to analyze the clinical efficacy based on clinical follow-up results. Methods:(1) A utopsy morphology research:From September 2012 to November 2012, totally 46 a-dult cadaveric human shoulders were dissected in the Department of Anatomy, Xi njiang Medical University. The anatomical morphology of the acromioclavicular joi-nt was observed and the relevant morphological parameters of the ligament were m-easured. (2) Case analysis:Eleven patients who received coracoclavicular ligament reconstruction with the lateral half of the conjoined tendon and medial half of the coracoacromial ligament for repair of RockwoodⅢ acromioclavicular joint dislocatio-n from 2012 to 2014 were followed up. At the last follow-up visit, postoperative radiographic evaluation was done for the acromioclavicular joint recovery, and the American Shoulder and Elbow Surgeons (ASES) scores, Constant-Murley shoulder s-cores and UCLA shoulder scores, Simple Shoulder Test Form were adopted to ev-aluate the shoulder functions; visual analog scale scores were used for painevaluati-on. Results:(1) Results of autopsy morphology research:Detail morphology data o-f the acromioclavicular joint, its surrounding tissues and musculocutaneousnerve we-re given, which provide the anatomical data for operation at this region. (2) Resul-t of case analysis:After 2-24 months of follow-up, the mean ASES score was (9 2.30±1.89), the mean Coustant-Murley score was (90.34±1.75), the mean UCLA s-houlder score was (31.26±1.46), and the mean visual analog scale score for pain w -as(1.34±1.06). No statistical significance compared with the contralateral respectivel-y. The number of positive answer to the Simple Shoulder Test Form was 9, and the overall excellent rate was 90.9%(10/11). Poor results were found in one case. Conclusion:Through the anatomical reconstruction of the static stability (such as coracoclavicular ligaments) and dynamic stability (such as joint capsule, trapezius muscle and deltoid muscle) of the acromioclavicular joint, the anatomical reduction of the acromioclavicular joint can be implemented, the double-beam coracoclavicula-r ligament reconstruction using the conjoined tendon and coracoacromial ligament i-s an effective method to repair RockwoodⅢ acromioclavicular joint dislocation.