Arthroscopically assisted coraco-clavicular ligament reconstruction in treatment of acute displaced distal clavicle fractures provides good to excellent shoulder function despite low union rates and high complication rates. A systematic review.

Malik, Shahbaz S, Tahir, Muaaz, Malik, Sheraz, Kwapisz, Adam and Jordan, Robert W (2021) Arthroscopically assisted coraco-clavicular ligament reconstruction in treatment of acute displaced distal clavicle fractures provides good to excellent shoulder function despite low union rates and high complication rates. A systematic review. Arthroscopy: the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association. ISSN 1526-3231.

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Official URL: https://www.arthroscopyjournal.org/article/S0749-8...

Abstract

PURPOSE

The aim of this systematic review was to assess the clinical outcome of arthroscopically assisted coraco-clavicular ligament (AACCL) reconstruction for treatment of displaced distal clavicle fractures in terms of union rate, complications and shoulder function.

METHODS

A review of the online databases MEDLINE and Embase was conducted on 1 January 2021 according to PRISMA guidelines. The review was registered prospectively in the PROSPERO database. Clinical studies reporting union rate, complications and shoulder function were included. The studies were appraised using the Methodological Index for Non-Randomized Studies (MINORS) tool.

RESULTS

The search strategy identified 14 studies eligible for inclusion, 12 retrospective case series and 2 nonrandomized retrospective comparative studies. All studies reported on shoulder function, union rate and complications. The overall shoulder function was good to excellent according to Constant-Murley score with mean scores ranging from 81.8 to 96.2 [I (inconsistency) = 0% (95% CI = 0% to 61%)]. The mean union rate ranging from 70% to 100% [I (inconsistency) = 32.6% (95% CI = 0% to 63.4%)] and the mean complication rate ranging from 0 to 28.6% [I (inconsistency) = 43.4% (95% CI = 0% to 68.4%)]. The commonest complications were hardware related (3.1%), wound related (2.7%) and post-operative shoulder stiffness (2.2%).

CONCLUSION

This systematic review has analysed clinical studies that evaluated the outcome of AACCL reconstruction in displaced distal clavicle fractures. The overall findings of this SR are that the union rate can be as low as 70% with this technique and complication rate as high as 28.6%. The overall shoulder function was good to excellent according to Constant-Murley score. As the literature surrounding this topic is heterogenous, further comparative clinical studies are required to assess superiority compared to other traditional techniques LEVEL OF EVIDENCE: Systematic review of Level III and IV studies.

Item Type: Article
Subjects: WE Musculoskeletal. Orthopaedics
Divisions: Planned IP Care > Trauma and Orthopaedics
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Depositing User: Mrs Caroline Tranter
Date Deposited: 02 Aug 2021 09:34
Last Modified: 02 Aug 2021 09:34
URI: http://www.repository.uhblibrary.co.uk/id/eprint/4519

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