Suture repair using loop technique in cases of acute complete acromioclavicular joint dislocation

Abstract

BackgroundAcromioclavicular joint dissociation may not be a common injury, yet it may cause limitations in activity. Types IV, V, and VI dissociations need operative repair. In this study, a simple technique is advocated to reduce and maintain reduction of the acromioclavicular joint using no. 5 nonabsorbable suture material while the resutured coracoclavicular (CC) ligament heals.Methods and methodsTwenty-one patients (16 men and five women) with types IV and V acromioclavicular joint dissociation were studied. In all cases, acromioclavicular joint was reduced and reduction was maintained using no. 5 nonabsorbable suture material passed as a loop under the knuckle of the coracoid process and through a tunnel drilled through the lateral third of the clavicle. The CC ligament was then resutured.ResultsPatients were followed up over a period of 6–9 years. At the final follow-up, all patients had returned to their preinjury level of activity, with significant improvement in the University of California Los Angeles (UCLA), American Shoulder and Elbow Surgeons Shoulder (ASES), and the Constant scores.ConclusionsThis technique provided good results with no loss of reduction, except in a single case, during the long follow-up period. We could not prove that the good results are due to the healing of the CC ligament. However, patients were able to return to their daily activities and even contact sports without any noticeable deformity, feeling of weakness, pain, or limitation of range of motion (compared with the contralateral side). This technique does not involve the use of metallic implants, which require another surgery to remove them, the use of expensive synthetic graft, or a graft harvested from a distant donor site.