Summary

The new coracoclavicular fixation technique using double button konts shows good biomechanical and clinical results and can be reasonable option for treatment of acute high grade acromioclavicular dislocation.

Abstract

Background

While several surgical techniques have been described for the treatment of acute and high-grade acromioclavicular (AC) dislocation, there is presently no surgical standard-of-care that truly restores normal AC joint kinematics.

Purpose

This study was conducted to assess the overall biomechanical safety, early clinical outcomes, and radiologic results of a new surgical technique involving a button knot in patients with acute and high-grade AC dislocation.

Study design: Descriptive Laboratory Study

Methods

The biomechanical apparatus included a cyclic loading test and load displacement curve test, which were performed to confirm the elongation of strands and ultimate tensile strength. Clinically, we assessed the coracoclavicular (CC) interval on radiographs and Constant-Murley functional scores at 12 months after surgery.

Results

Biomechanically, the mean elongation of stands during 1000 cycles was 0.52±0.21 mm in the cyclic loading test and the mean ultimate tensile strength was 982.8±67.3N in the load displacement curve test. The clinical measure of shoulder function, the Constant–Murley score, was 93.8±2.7 on the injured side versus 94.1±2.4 on the uninjured side. The radiographs of eight patients exhibited a displacement of less than 2 mm, while one patient had an increase in CC distance of more than 4 mm and one patient had an increase in CC distance between 2 and 4 mm.

Discussion

Our new surgical method for CC fixation, which uses a double button knots, exhibited favorable biomechanical and clinical outcomes. With biomechanical advantage and biological perspective in terms of multiple small sized tunnels, our new surgical technique would be a good option for treatment of acute and high-grade AC dislocation.