Technical Note Minimally Invasive Arthroscopic Acromioclavicular Joint Stabilization

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Date
2010-02-18
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The Thai Journal of Orthopaedic Surgery
Abstract
Techniques for stabilization acromioclavicular joint injuries remain a topic of considerable controversy. The fact that over hundred different surgical procedures for treating complete acromioclavicular separation are noted in the literature indicates that an optimal procedure has not been found for this condition. Pinning across joints was a common method for fixing acromioclavicular joint separation because it is simple and easy to apply. Unfortunately, many complications associated with pinning have been reported such as degenerative acromioclavicular joint disease, breakage and migration of the pins. Simple coracoclavicular cerclage causes anterior subluxation of the distal clavicle with malreduction of the acromioclavicular joint. Also with time, synthetic cerclage material such as wire or Dacron tape can wear through the bone amputating the clavicle or the coracoid. A Bosworth screw or hook plate requires removal of the implant to avoid breakage or bony erosion. Dynamic muscle transfer may allow excessive motion at the acromioclavicular joint and can lead to symptomatic joint instability and arthrosis, especially in older patientsDespite these numerous options of surgical methods, the minimally invasive stabilization of this injury has been rarely reported. The aim of this report is to propose a new technique for  stabilization of acromioclavicular joint dislocation using suture anchors with fiberwire tied over a small plate.
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The Thai Journal of Orthopaedic Surgery; Volume 31 Number 2 September 2006; 82 - 89