Why does minimally invasive coracoclavicular ligament reconstruction using a flip button repair technique fail? An analysis of risk factors and complications

  • Benedikt Schliemann
  • Steffen B. Roßlenbroich
  • Kristian N. Schneider
  • Christina Theisen
  • Wolf Petersen
  • Michael J. Raschke
  • André Weimann
Shoulder
First Online:
Received:
Accepted:

Abstract

Purpose

Aim of the present study was to evaluate the risk factors for the failure of coracoclavicular ligament reconstruction using a flip button repair technique and to analyse complications related to this procedure.

Methods

Seventy-one patients (3 female, 68 male) underwent surgical treatment using a flip button repair technique for an acute acromioclavicular joint dislocation. The following factors and its impact on clinical and radiographic outcome were assessed: age at trauma, interval between trauma and surgery, degree of displacement (according to Rockwood’s classification), coracoid button position, button migration and post-operative appearance of ossifications.

Results

Sixty-three patients were available for follow-up. The overall Constant score was 95.2 points (range 61–100 points) compared to 97 points (range 73–100 points) for the contralateral side (p = 0.05). Nine patients (14.3 %) needed surgical revision. Inappropriate positioning of the coracoid bone tunnel with subsequent button dislocation was the most frequently observed mode of failure (6 cases, 9.5 %). Button migration into the clavicle was associated with loss of reduction (p = 0.02). The patient’s age at the time of trauma had a significant impact on the clinical outcome, whereas younger patients achieved better results (p = 0.02). The interval between trauma and surgery did not significantly affect the outcome (n.s.).

Conclusion

Good to excellent clinical results can be achieved with the presented surgical technique. The age of the patient at trauma had a significant influence on the functional outcome. Furthermore, placement of the coracoid button centrally under the coracoid base is crucial to prevent failure.

Level of evidence

IV.

Keywords

Acromioclavicular joint dislocation Coracoclavicular ligaments Rockwood’s classification Coracoclavicular ligament augmentation 
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Notes

Acknowledgments

The authors thank Birgit Drews and Susanne Amler for their help in preparation of the manuscript.

Conflict of interest

W.P. is a consultant for the Karl Storz Company. The other authors report no conflict of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Benedikt Schliemann
    • 1
  • Steffen B. Roßlenbroich
    • 1
  • Kristian N. Schneider
    • 1
  • Christina Theisen
    • 1
  • Wolf Petersen
    • 2
  • Michael J. Raschke
    • 1
  • André Weimann
    • 1
  1. 1.Department of Trauma, Hand and Reconstructive SurgeryUniversity Hospital MünsterMünsterGermany
  2. 2.Department of Orthopaedics and Trauma SurgeryMartin-Luther HospitalBerlinGermany

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