An implant for fixation without addressing the CC ligament is likely to fail. Invariably mere K-wire fixations are likely to fail. This application has been extended to AC joint dislocations. The CC ligament is one of the strongest ligaments in the body. A synthetic graft or screw is unlikely to sustain cyclic loading forever.
The most common cause of discomfort is the scapular dyskinesia, which leads to medial scapular or posterior midthoracic pain or discomfort. Repair of complete acromioclavicular separations using the acromioclavicular-hook plate. The most common complaint in the late setting is a nagging medial scapular pain. Ashish Babhulkar declares that he has no conflict of interest. Bipolar clavicular dislocation treated surgically.
Treatment of acromioclavicular separations: Aditya Pawaskar declares that he has no thezis of interest. There are several versions of the anatomic approach, varying with biological ligament Semitendinoses, Gracilis, EHL, and even Palmaris longuspoint of fixation single clavicle hole or 2 holes. A semitendinoses graft is harvested and prepared by the standard technique.
Acromioclavicular joint dislocations
Bipolar clavicular dislocation treated surgically. Conservative treatment of acromioclavicular dislocation. The CC acromioclvicular is one of the strongest ligaments in the body. Coracoclavicular ligaments are the laterally located trapezoid ligament and the more medial conoid ligament. Postoperative after CC ligament reconstruction with Semi T graft.
The periosteal of the coracoid is abraded with a rasp on both sides to allow the donor graft to integrate with the coracoid. A significant number of patients have been treated conservatively for type III dislocations and hence, the recommendations for treating type III AC joint are controversial.
Acromioclavicular joint injuries in sport: There have been reports of high failure of mechanical devices oj 20 ].
It is, thus, difficult to pinpoint which patient will decompensate his or her shoulder biomechanics. Interposed in the joint is a fibrocartilaginous disk. Once the graft is passed around the coracoid one must ensure that the graft is not snagged in any tissue and is rotating smoothly.
Bring the 2 ends of the graft anterior to the clavicle. Simultaneously as the graft is being tightened, firm pressure is maintained on the lateral end of the clavicle, to reduce it into its anatomic location Fig.
A biomechanical evaluation of an anatomical coracoclavicular ligament reconstruction. When the clavicle drill hole is made lateral to the coracoid, the 2 strands of the graft chart a different vector, with each strand charting different course—mimicking the conoid and trapezoid path. J Shoulder Elbow Surg.
Support Center Support Center. Horizontal displacement can also be measured [ 10 ]. Eaton R, Serletti J. It is vital to evaluate reducibility of the vertical displacement, especially in chronic dislocations.
Radiographic features Anteroposterior, lateral, and axial views are standard views taken for afromioclavicular shoulder; however, a Zanca view [ 12 ] is the most accurate view to look at the AC joint.
Most common is type III. A cadaveric study examining acromioclavicular joint congruity after different methods of coracoclavicular loop repair.
By feeling the coracoid through the anterior deltoid, a split in Deltoid is created in line with its fibers to expose the coracoid. J Am Acad Orthop Surg. Operative technique ASB Technique We are describing here the anatomic technique of reconstructing the CC ligaments with afromioclavicular semitendinoses graft as described by the senior author.
Acromioclavicular joint dislocations
The force initially injures the acromioclavicular ligaments. Injuries to the acromioclavicular joint. The base of the coracoid is skeletonized through a rent in CA ligament and the Pectoralis Minor, without detaching these attachments. The 2 ends of the semitendinoses graft are then pulled through, underneath the deltoid.