Abstract：Objective This study aimed to compare the clinical effects of Tight Rope combined with anchor fixation and Tight Rope fixation on severe acromioclavicular dislocation. Methods A retrospective study was conducted, using the clinical data of 45 patients admitted to the Department of Orthopedics, Sir Run Run Hospital affiliated to Nanjing Medical University from April 2017 to December 2020 because of severe acromioclavicular dislocation. The patients were composed of 30 males and 15 females, aged 25-61 (47.8±10.5) years. According to Rockwood classification, 31 cases were type Ⅳ, and 14 cases were Type Ⅴ. Patients were divided into two groups according to different surgical methods. Twenty-five patients were treated with Tight Rope combined with anchor fixation, composed of 17 males and eight females and aged 25-60 (48.1±9.9) years. Twenty Tight Rope patients were treated with Tight Rope alone, composed of 14 males and six females and aged 27-61 (47.4±10.8) years. The clinical baseline data, surgical incision length, surgical duration, length of hospital stay, postoperative wound infection, joint mobility limitation, loosening of internal fixation, and other complications were compared between the two groups. Three months after surgery, the degree of pain in the affected limb was evaluated with the visual analog scale (VAS) score, and shoulder function was evaluated with the Constant-Murley Score (CMS) and University of California at Los Angeles (UCLA) shoulder scoring system. The vertical and horizontal stability of the clavicle was evaluated with orthographic and modified Alexander radiographs 3 months after the operation. Results No statistically significant differences were found in the baseline data of age, gender, injury site, injury cause, and injury to operation time between the two groups (all P values > 0.05). Patients in both groups successfully completed surgery, and no related complications occurred during surgery. No significant differences in surgical incision length, surgical duration, and hospital stay between the two groups (all P values > 0.05). One patient in Tight Rope + anchor group experienced delayed wound healing, and the wound was healed after corresponding treatment. All 45 patients were followed up for 6-26 months. During the follow-up period, no complications, such as joint movement limitation and internal fixation loosening, were found. Three months after surgery, the VAS score of the Tight Rope + anchor group was lower than that of the Tight Rope group, the CMS and UCLA scores were higher than those of the Tight Rope group, and the differences were statistically significant (t=2.96, 14.16, 18.26; all P values < 0.01). Three months after surgery, the vertical stability of the clavicle was evaluated by imaging. In the Tight Rope + anchor group, 20 cases were excellent, and five cases were good, with an excellent or good rate of 100.0% (25/25). In the Tight Rope group, 10 excellent cases, eight good cases, and two poor cases were found, and a rate of 90.0% (18/20) was obtained. No significant difference was found between the two groups (χ2=2.62,P=0.106). The horizontal stability of the clavicle was excellent in 20 cases and good in five cases in the Tight Rope + anchor group, and the good/good rate was 100.0% (25/25). In the Tight Rope group, five were excellent, 10 were good, and five were poor, with an excellent/good rate of 75.0% (15/20). The good rate of the Tight Rope + anchor group was higher than that of the Tight Rope group, and the difference was statistically significant (χ2=7.03, P=0.008). Conclusion Tight Rope fixation combined with anchor fixation is reliable in the treatment of severe acromioclavicular dislocation and can effectively reduce postoperative pain and improve the level of clavicle stability and shoulder function.
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2022, Vol. 27 
