2022, Number 2
Restoring horizontal stability in III-V acromioclavicular dislocations by anatomic reconstruction of the coracoclavicular and acromioclavicular ligaments; surgical technique
Language: Spanish
References: 16
Page: 128-133
PDF size: 295.00 Kb.
ABSTRACT
Introduction: dislocation of the acromioclavicular (AC) joint is a common injury seen in young adults. The objective is to describe a surgical technique that can restore the horizontal and vertical stability of the AC joint. Material and methods: we describe a surgical technique that can restore horizontal and vertical stability using an allograft for the anatomical reconstruction of the CC and AC ligaments, for AC grade III-V dislocations according to the Rockwood classification. Results: this is a surgical technique with anatomical and biological reconstruction of the CC and AC ligaments, using an allograft. Two bone tunnels are made in the clavicle, passing the lateral end of the graft below the acromion; then the two ends are fixed with two bioabsorbable screws, restoring vertical and horizontal stability. Conclusion: this procedure allows to restore the vertical and horizontal stability of the AC joint. Follow up studies are required to report functional and radiological results, in order to ensure advantages compared to existing techniques.REFERENCES
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Berthold DP, Muench LN, Beitzel K, Archambault S, Jerliu A, Cote MP, et al. Minimum 10-year outcomes after revision anatomic coracoclavicular ligament reconstruction for acromioclavicular joint instability. Orthop J Sports Med [Internet]. 2020; 8(9): 2325967120947033. Available in: https://doi.org/10.1177/2325967120947033
Muench LN, Kia C, Jerliu A, Murphy M, Berthold DP, Cote MP, et al. Functional and radiographic outcomes after anatomic coracoclavicular ligament reconstruction for type III/V acromioclavicular joint injuries. Orthop J Sports Med [Internet]. 2019; 7(11): 2325967119884539. Available in: https://doi.org/10.1177/2325967119884539
Xu J, Liu H, Lu W, Li D, Zhu W, Ouyang K, et al. A retrospective comparative study of arthroscopic fixation in acute Rockwood type IV acromioclavicular joint dislocation: single versus double paired Endobutton technique. BMC Musculoskelet Disord [Internet]. 2018; 19(1): 170. Available in: https://doi.org/10.1186/s12891-018-2104-9
Tamaoki MJ, Lenza M, Matsunaga FT, Belloti JC, Matsumoto MH, Faloppa F. Surgical versus conservative interventions for treating acromioclavicular dislocation of the shoulder in adults. Cochrane Database Syst Rev [Internet]. 2019; 10: CD007429. Available in: https://doi.org/10.1002/14651858.CD007429.pub3
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Ruzbarsky JJ, Elrick BP, Nolte PC, Arner JW, Millett PJ. Grade III acromioclavicular separations treated with suspensory fixation techniques: a systematic review of level I through IV studies. Arthrosc Sports Med Rehabil [Internet]. 2021; 3(5): e1535-45. Available in: https://doi.org/10.1016/j.asmr.2021.04.003
EVIDENCE LEVEL
IV series de casos.