BACKGROUND: Many procedures, both nonoperative and operative, have been described for treatment of complete acromioclavicular dislocations. The best primary treatment, however, still remains unclear. PURPOSE: We present a new surgical technique in which the clavicle is reduced to an anatomic position, the coracoacromial ligament is transferred to the clavicle, and acromioclavicular joint fixation is accomplished with the use of absorbable, braided suture cord. METHODS: Twenty-one patients underwent the modified technique of reconstruction. Patients were included only if they had sustained a Rockwood type V acromioclavicular dislocation and were extremely active in competitive sports before dislocation occurred. RESULTS: Eighteen patients returned to their sports without pain within 2.5 months after operation. The mean follow-up was 35.7 months. The average Constant score at last follow-up was 97. Radiographs taken at this time confirmed anatomic reduction in 18 patients, residual subluxation in 2 patients, and, in 1 patient, redislocation of the joint that occurred because of infection. Six patients had radiographic evidence of coracoclavicular ossifications. All patients developed a wide scar. CONCLUSIONS: Considering its operative simplicity, the advantage of absorbable augmentation of the clavicular reduction, and the low rate of recurrence, this technique may be an attractive alternative in this particular group of patients.
BACKGROUND: Many procedures, both nonoperative and operative, have been described for treatment of complete acromioclavicular dislocations. The best primary treatment, however, still remains unclear. PURPOSE: We present a new surgical technique in which the clavicle is reduced to an anatomic position, the coracoacromial ligament is transferred to the clavicle, and acromioclavicular joint fixation is accomplished with the use of absorbable, braided suture cord. METHODS: Twenty-one patients underwent the modified technique of reconstruction. Patients were included only if they had sustained a Rockwood type V acromioclavicular dislocation and were extremely active in competitive sports before dislocation occurred. RESULTS: Eighteen patients returned to their sports without pain within 2.5 months after operation. The mean follow-up was 35.7 months. The average Constant score at last follow-up was 97. Radiographs taken at this time confirmed anatomic reduction in 18 patients, residual subluxation in 2 patients, and, in 1 patient, redislocation of the joint that occurred because of infection. Six patients had radiographic evidence of coracoclavicular ossifications. All patients developed a wide scar. CONCLUSIONS: Considering its operative simplicity, the advantage of absorbable augmentation of the clavicular reduction, and the low rate of recurrence, this technique may be an attractive alternative in this particular group of patients.
Authors: Keith Baldwin; Surena Namdari; Jaron R Andersen; Brian Lee; John M Itamura; G Russell Huffman Journal: Clin Orthop Relat Res Date: 2009-05-07 Impact factor: 4.176