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Background <p>The optimal management of acute Rockwood type III acromioclavicular joint (ACJ) disruptions remains controversial. Although conservative treatment is recommended for many patients, surgical stabilization may benefit selected high-demand individuals. This study evaluated the radiographic and functional outcomes of percutaneous double-endobutton fixation in selected patients with acute Rockwood type III ACJ disruptions.</p> Methods <p>A prospective observational case series was conducted involving 16 consecutive patients with acute Rockwood type III ACJ disruptions treated using percutaneous double-endobutton fixation. Surgical treatment was offered to selected high-demand patients, including manual labourers, overhead athletes, individuals with dominant upper-extremity involvement, and those with cosmetic concerns. Functional outcomes were assessed using the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score. Radiographic outcomes were evaluated using coracoclavicular (CC) distance measurements. Patients were followed for a minimum of 6&#xa0;months, with extended 12-month follow-up available for 15 patients.</p> Results <p>The mean age was 33.9 ± 7.1&#xa0;years. The mean preoperative CC distance of 22.4&#xa0;mm improved to 10.8 ± 1.3&#xa0;mm immediately postoperatively and was maintained at 6&#xa0;months (11.1 ± 1.5&#xa0;mm) and 12&#xa0;months (11.8 ± 1.2&#xa0;mm). Mean QuickDASH scores improved from 46.9 ± 11.3 at 6&#xa0;weeks to 22.6 ± 11.1 at 3&#xa0;months, 12.3 ± 7.0 at 6&#xa0;months, and 7.6 ± 2.0 at 12&#xa0;months. All patients achieved full shoulder range of motion comparable to the contralateral side. Median return to unrestricted activity was 13&#xa0;weeks. One patient (6%) demonstrated asymptomatic loss of reduction. No implant failures, infections, neurovascular injuries, reoperations, or major complications occurred.</p> Conclusion <p>Percutaneous double-endobutton fixation provided reliable maintenance of reduction, excellent functional recovery, favorable cosmetic outcomes, and a low complication rate in selected acute Rockwood type III ACJ disruptions. Larger comparative studies with longer follow-up are required to define its role relative to non-operative treatment and alternative surgical techniques.</p>

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Percutaneous double-endobutton fixation for selected acute rockwood type III acromioclavicular joint disruptions: early and mid-term outcomes of a prospective case series

  • 期刊论文

  • 发表日期：

    2026年6月25日

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  • Saurav Narayan Nanda,
  • Sumit Kaushik,
  • Hari Krishna Gutta,
  • Rishab Kafley,
  • Rahul Adwani,
  • Aritra Paul

摘要

Background

The optimal management of acute Rockwood type III acromioclavicular joint (ACJ) disruptions remains controversial. Although conservative treatment is recommended for many patients, surgical stabilization may benefit selected high-demand individuals. This study evaluated the radiographic and functional outcomes of percutaneous double-endobutton fixation in selected patients with acute Rockwood type III ACJ disruptions.

Methods

A prospective observational case series was conducted involving 16 consecutive patients with acute Rockwood type III ACJ disruptions treated using percutaneous double-endobutton fixation. Surgical treatment was offered to selected high-demand patients, including manual labourers, overhead athletes, individuals with dominant upper-extremity involvement, and those with cosmetic concerns. Functional outcomes were assessed using the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score. Radiographic outcomes were evaluated using coracoclavicular (CC) distance measurements. Patients were followed for a minimum of 6 months, with extended 12-month follow-up available for 15 patients.

Results

The mean age was 33.9 ± 7.1 years. The mean preoperative CC distance of 22.4 mm improved to 10.8 ± 1.3 mm immediately postoperatively and was maintained at 6 months (11.1 ± 1.5 mm) and 12 months (11.8 ± 1.2 mm). Mean QuickDASH scores improved from 46.9 ± 11.3 at 6 weeks to 22.6 ± 11.1 at 3 months, 12.3 ± 7.0 at 6 months, and 7.6 ± 2.0 at 12 months. All patients achieved full shoulder range of motion comparable to the contralateral side. Median return to unrestricted activity was 13 weeks. One patient (6%) demonstrated asymptomatic loss of reduction. No implant failures, infections, neurovascular injuries, reoperations, or major complications occurred.

Conclusion

Percutaneous double-endobutton fixation provided reliable maintenance of reduction, excellent functional recovery, favorable cosmetic outcomes, and a low complication rate in selected acute Rockwood type III ACJ disruptions. Larger comparative studies with longer follow-up are required to define its role relative to non-operative treatment and alternative surgical techniques.