Mid term rsults of management of acromioclavicular injuries with tension band wiring

Introduction: Acromioclavicular (AC) joint injuries represent a broad spectrum that can result in mild, transient pain to significant displacement, chronic pain & altered shoulder biomechanics resulting in disability. The aim & objective of this study is mainly to analyze the functional outcome of complete acromioclavicular injuries treated with modified Tension Band Wiring. 30 cases of acromioclavicular disruption (type III-V) were treated with open reduction and modified tension band wiring. Closed acromioclavicular joint injuries (Rockwood and Young type III-VI) with acute onset in between 20-65 years were included. Chronic disruption & compound injuries were excluded. After obtaining anaesthetic fitness, open reduction & modified tension band wiring was done. Post operative X-rays assessed. All patients underwent a standardized post operative protocol with imobilisation in strapping for 21 days. Gentle shoulder mobilization started after 3 weeks. Functional outcome assessed at regular interval at 6,12,24 weeks using DASH & CONSTANT scores.
Results: At the last follow-up, 28 patients had an excellent outcome as assessed by two scoring systems The Constant score & DASH scores. One patients had good outcome. One patient had fair outcome.
Conclusion: Modified Tension band wiring in traumatic Acromioclavicular injuries has resulted in excellent functional outcome. Eventhough there is risk of breakage of implant and need for implant removal it has the advantage of being cost effective & gold standard method.