Variations in method in the use of the coracoacromial ligament for the surgical treatment of acromioclavicular dislocations.

ABSTRACT

Many authors have used the coracoacromial ligament to treat acromioclavicular dislocations. The variation in method proposed in this study includes a) detachment of the coracoacromial ligament from the acromial aspect, b) its section into two bands, medial and lateral, of which one inserted by means of a transosseous hole at the clavicle and the second one anchored bridge-like on the clavicle suturing it to the soft tissues; c) temporary fixation of the acromioclavicular joint by means of a Kirschner wire or Ghisellini screw pin that is threaded at one end. The study conducted may be considered preliminary, as the series is constituted by 16 patients affected with grade IV acromioclavicular displacement according to Rockwood, acute in 13 cases and inveterate in 3. The results which were excellent and good in terms of pain, recovery of range of movement, and the subjective opinion of the patients, reveals a subdislocation measuring from 3 to 5 mm in 2 patients in our series. Currently, the hypothesis may be advanced that the variation in the method described may have the advantage of guaranteeing physiological anchoring of the ligament to the clavicle and thus providing a greater guarantee should trauma occur in the future.