Treatment of Type V Acromioclavicular Separation with Minimally Invasive Closed-loop Double-endobutton Technique
Background: Acromioclavicular (AC) separation is a prevalent shoulder girdle injury, accounting for 50% of all sports-related shoulder injuries. Surgery is recommended for Rockwood Types IV-VI injuries. In such cases, AC joint congruity and coracoclavicular ligament complex integrity are prerequisit...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2025-01-01
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| Series: | Formosan Journal of Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.4103/fjmd.FJMD-D-23-00039 |
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| Summary: | Background:
Acromioclavicular (AC) separation is a prevalent shoulder girdle injury, accounting for 50% of all sports-related shoulder injuries. Surgery is recommended for Rockwood Types IV-VI injuries. In such cases, AC joint congruity and coracoclavicular ligament complex integrity are prerequisites for robust scar tissue healing.
Objectives:
This study aimed to describe our indirect reduction procedure using a minimally invasive, closed-loop, double endobutton (Tightrope) technique for Type V AC separation and evaluate short-term outcomes and complications.
Materials and Methods:
A total of 51 patients with Rockwood Type V AC separation underwent surgery using the Tightrope technique between January 2017 and December 2021. Clinical and radiological outcomes were assessed using the Constant–Murley score with documentation of complications.
Results:
Patients were divided into three groups based on the amount of reduction: Good reduction (16, 31.4%), partial reduction loss (25, 49%) and complete reduction loss (10, 19.6%). Notably, no statistically significant differences were observed between the first two groups. However, the complete reduction loss group demonstrated significantly lower Constant–Murley scores.
Conclusions:
The Tightrope technique is a promising approach for Rockwood Type V AC separation, yielding favorable clinical outcomes; however, radiographic findings may not be satisfactory. While partial reduction loss had minimal impact, complete loss was associated with inferior results. Therefore, precise tightrope placement and avoidance of coracoid tip positioning are crucial for optimal outcomes. |
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| ISSN: | 2210-7940 2210-7959 |