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ORIGINAL ARTICLE
Year : 2013  |  Volume : 48  |  Issue : 2  |  Page : 156-162

Anatomic reconstruction of the coracoclavicular ligament in a recent acromioclavicular joint dislocation


Department of Orthopedics, Faculty of Medicine, Zagazig University, Zagazig, Egypt

Correspondence Address:
Mohamed El-Soufy
MD, Department of Orthopedics, Faculty of Medicine, Zagazig University, Zagazig
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.7123/01.EOJ.0000428911.76797.62

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Background

Injuries to the acromioclavicular (AC) joint are common, representing about 9% of all shoulder injuries. They are graded according to the Rockwood classification system. The rationale of surgical treatment is to restore normal anatomy, enabling patient to regain normal shoulder function. A wide variety of surgical procedures have been reported, including transarticular pins or screws; AC wire or suture fixation; coracoclavicular (CC) screws; and CC fixation with synthetic grafts.

Patients and methods

This was a prospective series of 12 patients with acute grades III–V AC joint dislocations through anatomic reconstruction of the coracoclavicular ligament using autogenous semitendinosus tendon. There were 10 men and two women ranging in age from 20 to 45 years (mean 30.25 years). The right shoulder was involved in eight patients (67%) and the left shoulder was involved in four (33%). The primary diagnosis was AC joint dislocation Rockwood type III in seven patients, type IV in four, and type V in one.

Results

The mean follow-up period was 14.3 months (12–18 months). On the visual analogue scale, the pain improved from an average 6.2 points preoperatively to an average of 2.3 points postoperatively. The procedure allowed for both satisfactory functional outcome and a low complication rate, with excellent or good results in 92% of the patients, with full return to previous activities in 12 months.

Conclusion

CC reconstruction using a semitendinosus tendon graft provides satisfactory results. This method aims at a reconstruction in which the course of the slings of the tendon is very close to the course of the original CC ligaments.



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