Acromioclavicular dislocations: treatment by transfer of the conjoined tendon and distal end of the coracoid process to the clavicle.

A retrospective study of 23 acute and 6 chronic acromioclavicular dislocations treated by surgical transfer of the distal 1/2 inch of the coracoid process with the attached conjoined tendon of the coracobrachialis and short head of the biceps to the clavicle revealed 14 excellent, 14 good and one fair result. Results were determined according to symptoms, range of motion at the shoulder and elbow, strength, anatomic reduction, and return to previous activities. Although most patients with this injury are treated conservatively, this procedure is reserved for the athlete or manual laborer below age 45 years, especially with involvement of the dominant-extremity. The 29 cases were evaluated 20--108 months following surgery. Thirteen additional cases with less than 18 month follow-up have also been good or excellent. Weakness and pain have not been as pronounced following this procedure in vigorous individuals as have been noted after conservative treatment. Few postoperative complications developed, and early return to competitive athletics was possible.