This pt several yrs ago suffered an AC separation, 3d degree , and did not treat it surgically and has had more and more symptoms
MRI study revealed that he had no intrinsic shoulder abnormalities, and it was felt that he was a candidate for reconstruction of the coracoclavicular ligaments, reduction of the AC separation and resection of the distal clavicle.
Careful dissection was carried out.
A small portion of the deltoid was detached from the anterior portion of the clavicle. This exposed the undersurface of the clavicle, which was exposed superiorly, anteriorly and posteriorly.
Using a large key elevator underneath the clavicle, distal portion of the clavicle was resected. This was approximately 2.5 cm. The sharp edges were then smoothed.
The coracoid process was identified and using a vascular clamp passed from medical to lateral underneath the coracoid process, and two #5 FiberWire sutures were passed at the base of the coracoid.
Two drill holes were made in the distal clavicle portion.
Using a suture passer, the FiberWire was captured and brought up to the superior aspect of the clavicle.
With AC joint, reduced by elevating the shoulder and pressing down on the clavicle, the sutures were tied.
This reduced the AC joint appropriately.
Repair of the deltopectoral interval and the deltoid was performed with 0 Vicryl.
23552 ?
23120 ?
Thank you!
MRI study revealed that he had no intrinsic shoulder abnormalities, and it was felt that he was a candidate for reconstruction of the coracoclavicular ligaments, reduction of the AC separation and resection of the distal clavicle.
Careful dissection was carried out.
A small portion of the deltoid was detached from the anterior portion of the clavicle. This exposed the undersurface of the clavicle, which was exposed superiorly, anteriorly and posteriorly.
Using a large key elevator underneath the clavicle, distal portion of the clavicle was resected. This was approximately 2.5 cm. The sharp edges were then smoothed.
The coracoid process was identified and using a vascular clamp passed from medical to lateral underneath the coracoid process, and two #5 FiberWire sutures were passed at the base of the coracoid.
Two drill holes were made in the distal clavicle portion.
Using a suture passer, the FiberWire was captured and brought up to the superior aspect of the clavicle.
With AC joint, reduced by elevating the shoulder and pressing down on the clavicle, the sutures were tied.
This reduced the AC joint appropriately.
Repair of the deltopectoral interval and the deltoid was performed with 0 Vicryl.
23552 ?
23120 ?
Thank you!