Surgical techniques and therapeutic results of anatomical reconstruction of coracoclavicular ligaments for acromioclavicular joint dislocations

Generally, the surgical treatment for traumatic acromioclavicular joint dislocation is recommended for type 5 according to Rockwood's classification. We believe that anatomical restoration of coracoclavicular ligament could best restore the function of the acromioclavicular joint. We attempted to correctly reconstruct the anatomy of the coracoclavicular ligament (trapezoid and conoid ligaments) in which the ipsilateral palmaris longus tendon and Endobutton were used as the reconstructing ligament and fixation material, respectively. Cross-sectional study. The subjects were 16 patients (15 men and one woman). The mean age at the time of the surgery was 38.6 years. The mean time of the surgery from the injury was 16.3 days. The mean duration of postoperative follow-up was one year and 5 months. The reduction in the acromioclavicular joint was complete in 10 of 16 patients. Meanwhile, the subluxation that represented less than 5 mm superior translation of the clavicle, occurred only in 5, that represented 5-10 mm superior translation in none, and the complete dislocation occurred in one patient. Concerning the range of motion, mean forward flexion was 171A degrees, mean abduction was 165A degrees, mean internal rotation was Th11, and mean horizontal adduction was 132A degrees. Pain, fatigues on the shoulder girdle, and impairments with shoulder motion on the affected side disappeared one month after surgery. Although it requires excision of the ipsilateral palmaris longus for graft, we believe that anatomical restoration of both coracoclavicular ligaments could best restore the function of the acromioclavicular joint.