Abstract
Numerous procedures have been described for the operative management of acromioclavicular (AC) joint injuries. Some of these techniques, including hardware fixation and non-anatomical reconstructions, are associated with serious complications and high failure rates. Recently, AC joint reconstruction techniques have focused on anatomical restoration of the coracoclavicular ligaments to achieve optimal clinical outcomes. We used a triple endobutton technique to separately reconstruct the trapezoid and the coronoid portions of the coracoclavicular ligament. We evaluated the preliminary clinical and radiological results of this technique in patients with acute complete dislocation of the AC joint. All patients achieved a significant improvement in the pain and function of shoulder at a mean follow-up interval of 12 months (range, 8–14 months). Excellent reduction of the AC joint was maintained. The triple endobutton technique may be safe and effective for the treatment of acute complete AC joint dislocations.
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Baek SH, Oh CW, Wallace WA, Jeon IH (2007) Anterior clavicle dislocation associated with acromioclavicular dislocation in a soccer player: a case report. Am J Sports Med 35(10):1752–1755. doi:10.1177/0363546507302918
Bradley JP, Elkousy H (2003) Decision making: operative versus nonoperative treatment of acromioclavicular joint injuries. Clin Sports Med 22:277–290. doi:10.1016/S0278-5919(02)00098-4
Calvo E, Lopez-Franco M, Arribas IM (2006) Clinical and radiologic outcomes of surgical and conservative treatment of type III acromioclavicular joint injury. J Shoulder Elbow Surg 15:300–305. doi:10.1016/j.jse.2005.10.006
Chernchujit B, Tischer T, Imhoff AB (2006) Arthroscopic reconstruction of the acromioclavicular joint disruption: surgical technique and preliminary results. Arch Orthop Trauma Surg 126:575–581. doi:10.1007/s00402-005-0073-6
Cooper ES (1861) New method for treating longstanding dislocations of the scapuloclavicular articulation. Am J Med Sci 41:389–392. doi:10.1097/00000441-186104000-00006
Debski RE, Parsons IM, Fenwick J, Vangura A (2000) Ligament mechanics during three degree-of-freedom motion at the acromioclavicular joint. Ann Biomed Eng 28:612–618. doi:10.1114/1.1304848
Flik K, Lyman S, Marx RG (2005) American collegiate men’s ice hockey: an analysis of injuries. Am J Sports Med 33:183–187. doi:10.1177/0363546504267349
Fukuda K, Craig EV, An KN, Cofield RH, Chao EY (1986) Biomechanical study of the ligamentous system of the acromioclavicular joint. J Bone Joint Surg Am 68:434–440
Greenberg JA, Fernandez JJ, Wang T, Turner C (2003) Endobutton-assisted repair of distal biceps tendon ruptures. J Shoulder Elbow Surg 12:484–490. doi:10.1016/S1058-2746(03)00173-3
Habernek H, Weinstabl R, Schmid L, Fialka C (1993) A crook plate for treatment of acromioclavicular joint separation: indication, technique, and results after one year. J Trauma 35(6):893–901
Harris RI, Wallace AL, Harper GD, Goldberg JA, Sonnabend DH, Walsh WR (2000) Structural properties of the intact and the reconstructed coracoclavicular ligament complex. Am J Sports Med 28:103–108
Koukakis A, Manouras A, Apostolou CD, Lagoudianakis E, Papadima A, Triantafillou C et al (2008) Results using the AO hook plate for dislocations of the acromioclavicular joint. Expert Rev Med Devices 5(5):567–572. doi:10.1586/17434440.5.5.567
Larsen E, Bjerg-Nielsen A, Christensen P (1986) Conservative or surgical treatment of acromioclavicular dislocation: a prospective controlled randomized study. J Bone Joint Surg Am 68:552–555
Lee SJ, Nicholas SJ, Akizuki KH, McHugh MP, Kremenic IJ, Ben-Avi S (2003) Reconstruction of the coracoclavicular ligaments with tendon grafts: a comparative biomechanical study. Am J Sports Med 31:648–655
Lemos MJ (1998) The evaluation and treatment of the injured acromioclavicular joint in athletes. Am J Sports Med 26:137–144
Lim YW (2008) Triple endobuttton technique in acromioclavicular joint reduction and reconstruction. Ann Acad Med Singapore 37:294–299
Mazzocca AD, Santangelo SA, Johnson ST, Rios CG, Dumonski ML, Arciero RA (2006) A biomechanical evaluation of an anatomical coracoclavicular ligament reconstruction. Am J Sports Med 34:236–246. doi:10.1177/0363546505281795
Nadarajah R, Mahaluxmivala J, Amin A, Goodier DW (2005) Clavicular hook-plate: complications of retaining the implant. Injury 36(5):681–683. doi:10.1016/j.injury.2004.08.010
Renfree KJ, Riley MK, Wheeler D, Hentz JG, Wright TW (2003) Ligamentous anatomy of the distal clavicle. J Shoulder Elbow Surg 12(4):355–359. doi:10.1016/S1058-2746(03)00029-6
Rios CG, Arciero RA, Mazzocca AD (2007) Anatomy of the clavicle and coracoid process for reconstruction of the coracoclavicular ligaments. Am J Sports Med 35(5):811–817. doi:10.1177/0363546506297536
Rockwood CA, Williams G, Young D (1990) Disorders of the acromioclavicular joint. In: Rockwood CA, Matsen FA (eds) The shoulder, 2nd edn. Philadelphia, Saunders, pp 483–553
Spencer EE Jr (2007) Treatment of grade III acromioclavicular joint injuries: a systematic review. Clin Orthop Relat Res 455:38–44. doi:10.1097/BLO.0b013e318030df83
Struhl S (2007) Double endobutton technique for repair of complete acromioclavicular joint dislocations. Tech Shoulder Elbow Surg 8(4):175–179. doi:10.1097/BTE.0b013e31815907a3
Weaver JK, Dunn HK (1972) Treatment of acromioclavicular injuries, especially complete acromioclavicular separation. J Bone Joint Surg Am 54:1187–1194
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Wei, HF., Chen, YF., Zeng, BF. et al. Triple endobuttton technique for the treatment of acute complete acromioclavicular joint dislocations: preliminary results. International Orthopaedics (SICOT) 35, 555–559 (2011). https://doi.org/10.1007/s00264-010-1057-x
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DOI: https://doi.org/10.1007/s00264-010-1057-x