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CORACOCLAVICULAR SUTURES FOR ACROMIOCLAVICULAR DISLOCATIONS: A TWO MIN-OPEN APPROACH

Authors: Simoni et al.

References: ICSS, Washington, 2004

Abstract
 Introduction: Treatment of acromioclavicular dislocations have always been controversial in deciding between conservative or surgical approaches. Many different techniques have been described and some of them using coracoclavicular sutures. There has been support on recent literature for coracoclavicular sutures with non-absorbable strong polyester sutures passing under the coracoid and through holes of the clavicle. However these procedures have some problems frequently described. Taking the deltoid from the clavicle and passing the sutures under the coracoid process were consistently technical problems. To solve these problems a two mini-open approach was developed and performed for the last 2 years in our department.  Material and Methods: There were 11 shoulders in 11 patients, all male. Their ages were between 16 and 38 years old with an average of 26.3 years old. There were 7 right and 4 left shoulders. A 2cm incision is performed over the coracoid process that is easily dissected. Two number 2 Fiberwire sutures (Arthrex) are passed under the coracoid and the deltotrapezial fascia and muscle envelope are open to expose the bone. Through 4 clavicle holes and a wire suture retriever the sutures are tied over the clavicle after reduction.  Results and Conclusions: With a minimum of 6 months to of follow-up there was 1 residual sub-luxation but with good function. All patients had full range of motion and normal strength. The two mini-open approach for coracoclavicular sutures method of treating AC dislocations is a good and easily performed option solving some technical problems of this procedure.

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