Suture repair using loop technique in cases of acute complete acromioclavicular joint dislocation

Abstract

BackgroundAcromioclavicular joint dissociation may not be a common injury, yet it may cause limitations in activity. Types IV, V, and VI dissociations need operative repair. In this study, a simple technique is advocated to reduce and maintain reduction of the acromioclavicular joint using no. 5 nonabsorbable suture material while the resutured coracoclavicular (CC) ligament heals.Methods and methodsTwenty-one patients (16 men and five women) with types IV and V acromioclavicular joint dissociation were studied. In all cases, acromioclavicular joint was reduced and reduction was maintained using no. 5 nonabsorbable suture material passed as a loop under the knuckle of the coracoid process and through a tunnel drilled through the lateral third of the clavicle. The CC ligament was then resutured.ResultsPatients were followed up over a period of 6–9 years. At the final follow-up, all patients had returned to their preinjury level of activity, with significant improvement in the University of California Los Angeles (UCLA), American Shoulder and Elbow Surgeons Shoulder (ASES), and the Constant scores.ConclusionsThis technique provided good results with no loss of reduction, except in a single case, during the long follow-up period. We could not prove that the good results are due to the healing of the CC ligament. However, patients were able to return to their daily activities and even contact sports without any noticeable deformity, feeling of weakness, pain, or limitation of range of motion (compared with the contralateral side). This technique does not involve the use of metallic implants, which require another surgery to remove them, the use of expensive synthetic graft, or a graft harvested from a distant donor site.

Complete acromioclavicular joint dislocation treated with reconstructed ligament by trapezius muscle fascia and observation of fascial metaplasia

“…The AC and CC ligaments are the key to maintaining stability. To stabilize the lateral clavicle and AC joint, some authors have recommended surgical techniques that employ various suture materials or autograft/allograft tissues to reconstruct the CC ligament [22]. The use of the native coracoacromial ligament to reestablish AC joint stability was first described in 1972 by Weaver [2].…”

Clinical Effect of Acute Complete Acromioclavicular Joint Dislocation Treated with Micro-Movable and Anatomical Acromioclavicular Plate

“…Screws and in combination with ligament reconstruction were recommended in treatment of acute complete acromioclavicular joint dislocation, and potential complications of this technique include suture cutout 9 - 11 . Other surgical techniques to stabilize the lateral clavicle and acromioclavicular joint include reconstruction of the coracoclavicular ligament by using a variety of suture materials or using autograft or allograft tissues 12 . The use of native coracoacromial ligament to reestablish acromioclavicular joint stability was first described in 1972 by Weaver 13 .…”

Acromioclavicular joint dislocation treated with Bosworth screw and additional K-wiring: results after 7.8 years – still an adequate procedure?

“…The acromioclavicular (AC) joint dislocation is a major reason for shoulder instability, typically associated with a direct high-energy trauma to the shoulder or strong force on the outstretched arm [ 1 – 3 ]. It often occurs in young and athletic patients emphasizing the importance of restoring normal anatomy and function for full recovery [ 4 ].…”

“…It often occurs in young and athletic patients emphasizing the importance of restoring normal anatomy and function for full recovery [ 4 ]. Different concepts of treatment and surgical methods, including a variety of implants, are described in the literature [ 3 , 4 ], however, no gold standard technique has yet been implemented [ 5 ]. Rockwood I and II lesions are normally treated non-surgically [ 6 ].…”

“…The use of Synthetic materials for fixation has become more popular, but despite a rapid development, these techniques can lead to serious complications such as incomplete reduction, ligament failure, foreign body reaction and fracture of the clavicle [ 7 , 8 ]. Metal implants offer immediate stabilization but are also often limited by implant failure [ 3 ]. The clavicle hook plate is often associated with a symptomatic impingement [ 9 ].…”