Study of clinical outcome of acromioclavicular joint injury type III-VI treated by EndoButton and threads in adults


  • Raghvendra Chaubey Department of Orthopaedics, Bundelkhand Medical College, Sagar, Madhya Pradesh, India
  • Deepak Kumar Mishra Department of Orthopaedics, Bundelkhand Medical College, Sagar, Madhya Pradesh, India
  • Rajesh Jain Department of Orthopaedics, Bundelkhand Medical College, Sagar, Madhya Pradesh, India



ASES score, Constant score, Rockwood classification, Acromioclavicular joint


Background: Acromioclavicular joint dislocations are common in physically active young adults that too most common in persons who are participating in sports activities. Incidence is more in males who are participating in contact sports like rugby, basketball, hockey. It accounts for 9% of all shoulder injuries. Literature says the incidence is 3-4/1,00,000 population. The aim of the present study was to study the functional outcome of acromioclavicular joint after reconstruction of both acromioclavicular and coracoclavicular ligament using endo button system and to provide pain-free, mobile shoulder.

Methods: In the present study, 15 patients were selected of age group 20-60 years. Acromioclavicular joint injuries are classified according to Rockwood classification and the findings from the physical examination and anteroposterior and axillary radiographs. All patients were treated as per status of injury level by either conservatively or operatively with open reduction and reconstruction of both ligament by using endo button thread system and its outcomes were assessed clinically and radiologically.

Results: Patients were evaluated using American shoulder and elbow score (ASES) score and Constant shoulder score. Average ASES score was 90 (range 68.3-98.3) and constant score was 88 (range 63-96). According to constant score 7 patients had excellent outcome, 6 patients had good outcome, 2 patients had adequate outcome. All patients reported satisfaction with the treatment. The patients were followed upto 6 months.

Conclusions: The technique proved to be effective in treating acute. Acromioclavicular joint dislocations (Rockwood type III-VI) with a high degree of patient satisfaction.

Author Biography

Raghvendra Chaubey, Department of Orthopaedics, Bundelkhand Medical College, Sagar, Madhya Pradesh, India

Senior resident doctor

Dept of orthopaedics


Kaplan LD, Flanigan DC, Norwig J, Jost P, Bradley J. Prevalence and variance of shoulder injuries in elite collegiate football players. Am J Sports Med. 2005;33(8):1142-6.

Singh B, Singh S, Saraf N, Farooque K, Sharma V. Unusual mechanism of injury with segmental fracture clavicle. J Orthop Surg. 2007;6(1):7.

Tamaoki MJ, Belloti JC, Lenza M, Matsumoto MH, Gomes Dos Santos JB, Faloppa F. Surgical versus conservative interventions for treating acromioclavicular dislocation of the shoulder in adults. Cochrane Database Syst Rev. 2010;8:CD007429.

Mazzocca AD, Arciero RA, Bicos J. Evaluation and treatment of acromioclavicular joint injuries. Am J Sports Med. 2007;35:316-29.

Urist MR. Complete dislocations of the acromiclavicular joint; the nature of the traumatic lesion and effective methods of treatment with an analysis of forty-one cases. J Bone Joint Surg Am. 1946;28(4):813-37.

Salter EG, Nasca RJ, Shelley BS. Anatomical observations on the acromioclavicular joint and supporting ligaments. Am J Sports Med. 1987;15:199-206.

Rockwood CA. Injuries to the acromioclavicular Joint. In: Rockwood CA, Green DP, eds. Fractures in Adults. 2nd ed. Philadelphia, PA: JB Lippincott; 1984: 860.

Williams GR, Nguyen VD, Rockwood CR. Classification and radiographic analysis of acromioclavicular dislocations. Appl Radiol. 1989;12:29-34.

Fukuda K, Craig EV, An KN, Cofield RH, Chao EY. Biomechanical study of the ligamentous system of the acromioclavicular joint. J Bone Joint Surg. 1986;68(3):434-40.

Mouhsine E, Garofalo R, Crevoisier X, Farron A. Grade I and II acromioclavicular dislocations: results of conservative treatment. J Shoulder Elbow Surg. 2003;12(6):599-602.

Nissen CW, Chatterjee A. Type III acromioclavicular separation: results of a recent survey on its management. Am J Orthop (Belle Mead NJ). 2007;36(2):89-93.






Original Research Articles