Functional and cosmetic outcomes in Peruvian patients with acromioclavicular joint dislocation: comparison between three surgical techniques

Vargas-Morales R.E.; Puga-Alvarez K.S. · Revista Facultad de Medicina (2024) · DOI: 10.15446/revfacmed.v72n3.112627

Resumen

Introduction: Acromioclavicular dislocation (AD) is a frequent and disabling injury. Depending on its type on the Rockwood classification, treatment may be conservative (I-II) or surgical (III-VI), although there is still no gold standard in terms of surgical technique. Objectives: To compare the functional outcomes and the level of patient satisfaction with the cosmetic outcome of three surgical techniques for AD treatment. Materials and methods: Retrospective comparative observational study conducted in 90 adult patients with AD (type III and V), who underwent surgery between January 2013 and August 2023 in four hospitals of Trujillo (Peru) with one of the following techniques: double sutures with bra strap incision (DS; n=30), hook plate (HP; n=30), and modified Phemister (MP; n=30). Questionnaires used to obtain information on functional outcomes and level of satisfaction with the cosmetic outcome were administered starting at the third postoperative month. Bivariate analyses were performed for comparisons between groups (KrusKall-Wallis and Chi-square tests), with a significance level of p<0.05. Results: The mean age of the patients was 42.41 years and 74.44% (n=67) were men. The Quick DASH questionnaire score was lower in the DS group (15.23±8.5) than in the other 2 groups (HP=17.64±10.4 and PM=25.96±6.7) (p=0.0002). Likewise, disability time (months) was shorter in the DS group (2.1±0.23) than in the other 2 groups (HP=4.66±1.22 and MP=2.93±1.18) (p=0.019). Finally, 61.11% of the patients reported being satisfied and totally satisfied with the cosmetic outcome, this proportion being higher with the DS technique (76.67%), followed by MP (60.00%), and HP (46.67%) (p<0.005). Conclusion: Among the three techniques evaluated, the DS technique showed better functional outcomes. Furthermore, the highest proportion of patients satisfied with the cosmetic outcome was found in the DS group.

Instituciones: Universidad Privada Antenor Orrego