Bosworth screw for acromioclavicular joint injuries: Indications and operative outcomes

• Main Authors: Kirtan Vijay Tankshali, Zulfikar M Patel, Hriday Prashant Acharya
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2020-01-01
• Series: Journal of Orthopedics, Traumatology and Rehabilitation
• Subjects: acromioclavicular joint injuries; bosworth screw; high-demanding occupation; rockwood classification
• Online Access: http://www.jotr.in/article.asp?issn=0975-7341;year=2020;volume=12;issue=1;spage=49;epage=52;aulast=Tankshali

Introduction: Acromioclavicular joint is a biomechanically complex joint, isolated injuries of which are rare. Complex classification system (Rockwood) and no universally approved guidelines for the treatment with the ever evolving surgical techniques pose further challenge for the treatment of the condition. We have in our current study, assessed operative outcomes of Bosworth screw fixation for AC joint injuries and the role of occupation in deciding treatment regimen and predict operative outcomes. Materials and Methods: This is a prospective cohort study of 11 patients having isolated AC joint injury classified as grade II or higher according to Rockwood classification treated with Bosworth screw fixation at high patient turnover tertiary care centre. Results: AC joint injuries are more common in males and RTA accounts for the most of the injuries. There is significant difference in outcomes of operative fixation between high demanding and low demanding occupation as evaluated by constant shoulder score (P < 0.01). Operative treatment in failed conservative treatment of type II/III injuries yields better constant score. The earlier the treatment, the earlier the vocational rehabilitation especially in high demanding occupation. Conclusion: Occupation should be considered in making treatment choice of AC joint injuries and not only type of injury. Bosworth technique of fixation is old but cost effective, easily reproducible, less time consuming technique with smaller learning curve and should be considered in all type V injuries and in patients with type II/III injuries involved in high demanding occupation.