Abstract：Objective This study aimed to investigate the short-term clinical effect of modified elastic fixation (modified Endobutton loop titanium plate) in the treatment of acute acromioclavicular dislocation. Methods This was a retrospective cohort study. A total of 46 patients with Rockwood types Ⅲ and Ⅳ acute acromioclavicular joint dislocation admitted to the Department of Orthopedics, Nanjing Jiangbei Hospital Affiliated to Nantong University from January 2020 to October 2021 were included in this study. Herein, 19 patients were included in the Endobutton improvement group, and the modified Endobutton loop titanium plate internal fixation was used, including 11 males and 8 females, aged 25-66 (40.1±10.8) years; 4 patients on the left side and 15 on the right; and types Ⅲ and Ⅳ with 7 and 12 patients, respectively. Meanwhile, 27 patients treated with acromioclavicular hook plate internal fixation were included in the acromioclavicular hook plate group, including 16 males and 11 females, aged 20-67 (36.4±10.0) years; 7 patients on the left side and 20 on the right; and types Ⅲ and Ⅳ with 11 and 16 patients, respectively. Observation indicators include the operation time, incision length, intraoperative blood loss, Constant-Murley score of shoulder joint function, and a visual analog scale score of shoulder joint pain at 1, 3, and 6 months after the operation. Postoperative complications were recorded and analyzed in the two groups. Results There was no significant difference in baseline clata between the two groups (all P values>0.05). All patients in the two groups successfully completed the operation and were followed up for more than 6 months. The operation time in the Endobutton improved group was (55.5±4.8) min, longer than that in the acromioclavicular plate group (42.6±5.5) min, the intraoperative blood loss was (33.7±7.1) mL, less than that in the acromioclavicular plate group (56.5±10.5) mL, and the incision length was (4.6±1.5) cm. The differences were statistically significant (t=8.23,-8.21,-4.69, all P values <0.001). At 1, 3, and 6 months after the operation, the two groups were significantly improved compared with the Constant-Murley score of the shoulder joint and VAS score, and the differences were statistically significant (all P values <0.05). At 1 and 3 months after the operation, the Constant-Murley score in the Endobutton improvement group was higher than that in the acromioclavicular hook plate group ([79.9±7.0] vs. [72.4±8.3] and [85.8±8.9] vs. [80.5±8.5] ), and VAS scores in the Endobutton improvement group were lower than that of the acromioclavicular hook plate group {(3.1±1.0) vs. (3.9±1.3) and (2[2,3]) vs. (3[2,3])}, and statistical significance was observed (all P values <0.05); 6 months after the surgery, VAS scores in both groups were 1(1,2) and 1(1,1), respectively, and Constant-Murley scores were (93.6±3.9) and (92.6±4.3), respectively, with no statistical significance (all P values >0.05). The incidence of complications in the Endobutton improvement group (2/19) was lower than that in the acromioclavicular plate group (29.63%,8/27), but the difference was not statistically significant (χ2=1.40, P=0.237). Conclusion Compared with acromioclavicular hook plate internal fixation in the treatment of acute acromioclavicular joint dislocation, the modified posterior Endobutton loop titanium plate internal fixation has better short-term clinical efficacy, with shorter incision, less intraoperative blood loss, better recovery of shoulder joint function, and less postoperative complications. However, the operation time is relatively longer.
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2023, Vol. 28 
