Acromioclavicular joint dislocation is a clinically common disease and caused by trauma violence. Patients often felt severe shoulder pain with limited mobility, seriously affecting daily life and work. Rockwood classification was mostly used in this disease. Because of its dislocation severity, damage structure characteristics and other reasons, the clinical treatment options of type III patients are often controversial. Fresh Rockwood III-IV type patients are clinically taken more surgical treatment, but the method is different. With the progress of materials and surgical concepts, new surgical techniques are becoming more widely used, and choosing a treatment that patients with this disease could get more benefits is a key issue for surgeons.

By collecting and comparing the surgical trauma and clinical efficacy indexes of AO clavicular hook plate and triple Endobutton technique in the treatment of fresh Rockwood typeⅢacromioclavicular dislocation, the correlation analysis was further carried out in the dominant group to explore the factors affecting the clinical efficacy, so as to provide reference for the improvement of surgical treatment of this kind of disease.

From January 2018 to May 2020, the data of 72 patients with fresh Rockwood typeⅢacromioclavicular dislocation were retrospectively analyzed. The patients were divided into AO clavicular hook plate group (Group A) and triple Endobutton group (Group B) according to the different operation methods. In Group A (n=37, F/M=12/25) , the average age was (41.30±1.02 ) years, and in the Group B (n=35, F/M=13/22) , the average age was (43.36±1.15) years. The X-ray examinations were performed on the 1st day, 1st week, 1st month, 3rd month and 1 year after surgery. Coracoclavicular joint distance and acromioclavicular joint distance were measured to evaluate the surgery reduction. The visual analogue scale (VAS) and Constant-Murley score were used to evaluate the clinic efficacy. The data were analyzed with Graphpad Prism 7 software. The age, rework time, injury to operation time, duration of surgery, surgical incision length, intraoperative blood loss, VAS score, Constant-Murley score, acromioclavicular joint distance and coracoclavicular joint distance were expressed as ±s. The gender and injured side were expressed quantitatively. The measurement data comparison among groups was analyzed by t test. The Chi-square test analysis and correlation analysis of enumeration data between groups was analyzed by Pearson correlation analysis. A value of P<0.05 was considered statistically significant, and r>0 was considered positively correlated.

Seventy two cases were followed up for 12 months. The results of Constant-Murley scores in Group A on the 1st day (46.60±0.41) and 1st week (65.22±0.45) after surgery were statistically significant lower (P<0.05) than those in Group B on the 1 day (51.30±0.39) and 1st week (75.07±0.35) after surgery. The results of VAS scores in Group A on the 1st day (6.71±0.07) , 1st week (5.45±0.09) and 1st month (3.70±0.11) after surgery were statistically significant higher (P<0.05) than those in Group B on the 1st day (5.70±0.10) , 1st week (3.60±0.14) and 1st month (2.00±0.10) after surgery. The results of rework time in Group A (7.64±0.10) week were statistically significant longer (P<0.05) than those in Group B (6.01±0.17) week. Finally, it was positive correlation between 1 day after surgery VAS scores (r= 0.73, P<0.05) and surgical incision length, the same results were found between 1 week after surgery VAS scores (r= 0.68, P<0.05) and surgical incision length. In group B, the incision length was positively correlated with VAS score of 1st day (r= 0.73, P<0.05) and 1st week (r= 0.68, P<0.05) after surgery.

The long-term effect of Endobutton technique and clavicular hook plate in the treatment of acromioclavicular joint dislocation is comparable. However, the advantages of Endobutton technique include small incision, less blood loss, better looking wound, pain relieve during early rehabilitation and fast restoration. In early postoperative recovery, Endobutton technique can shorten postoperative pain duration by reducing surgical trauma, which is worthy of clinical promotion.