scholarly journals Arthroscopic-Assisted Management of Unstable Distal-Third Clavicle Fractures: Conoid Ligament Reconstruction and Fracture Cerclage With Sutures

2015 ◽  
Vol 4 (6) ◽  
pp. e655-e661 ◽  
Author(s):  
Luis Natera Cisneros ◽  
Juan Sarasquete Reiriz
Keyword(s):  
Ligament Reconstruction ◽  
Clavicle Fractures ◽  
Assisted Management ◽  
Conoid Ligament

scholarly journals Distal Clavicle Fracture Repair: Clinical Outcomes of a Surgical Technique Utilizing a Combination of Cortical Button Fixation and Coracoclavicular Ligament Reconstruction

2019 ◽  
Vol 7 (9) ◽  
pp. 232596711986792 ◽  
Author(s):  
Gautam P. Yagnik ◽  
Charles J. Jordan ◽  
Raed R. Narvel ◽  
Robert J. Hassan ◽  
David A. Porter
Keyword(s):  
Postoperative Complications ◽  
Surgical Technique ◽  
Ligament Reconstruction ◽  
Distal Clavicle ◽  
Sf 36 ◽  
Cortical Button ◽  
Clavicle Fractures ◽  
The Mean ◽  
Radiographic Union ◽  
Distal Clavicle Fractures

Background: When treated conservatively, unstable distal clavicle fractures demonstrate a high symptomatic nonunion rate. While a variety of surgical techniques have been described, many of these techniques are associated with high failure rates and hardware-related complications. The surgical technique used in this study has shown promising biomechanical results; however, long-term clinical results have not yet been described. Purpose: To assess the clinical and radiological outcomes of a surgical technique for fixing displaced distal clavicle fractures using a combination of cortical button fixation and coracoclavicular (CC) ligament reconstruction. Study Design: Case series; Level of evidence, 4. Methods: We conducted a retrospective review of 22 consecutive patients with displaced, unstable Neer type II or V distal clavicle fractures who underwent this surgical technique from 2012 to 2019. Primary outcome variables were radiographic union, patient satisfaction, and postoperative shoulder function. Preoperative and postoperative University of California, Los Angeles (UCLA), and American Shoulder and Elbow Surgeons (ASES) scores were compared. Secondary outcome variables included intraoperative complications, postoperative complications, time to radiographic union, and preoperative and postoperative CC distance. Quality of life was assessed using preoperative and postoperative 36-Item Short Form Health Survey (SF-36) scores. Results: Nearly all (21/22) patients were available for a final review; 1 patient was lost to follow-up at 2 weeks. All 21 patients achieved radiographic union by 4 months (mean, 60.38 days; range, 41-84 days; 95% CI, 53.80-66.96 days). All patients were satisfied with the surgical procedure and their functional outcome. The mean UCLA score improved from 5.36 (95% CI, 4.14-6.60) preoperatively to 32.52 (95% CI, 30.56-34.48) postoperatively (mean difference, 27.14; P < .001). The mean ASES score improved from 16.23 (95% CI, 9.79-22.67) preoperatively to 88.11 (95% CI, 81.82-94.40) postoperatively (mean difference, 71.91; P < .001). Statistically significant improvements in SF-36 scores were seen in the physical functioning, role limitations due to physical health, pain, social functioning, and emotional well-being categories. There were 3 postoperative complications, including 1 patient with a minor complication secondary to hardware irritation, 1 patient with adhesive capsulitis, and 1 patient with wound dehiscence requiring wound closure. Conclusion: We describe a surgical technique for fixing displaced distal clavicle fractures using a combination of cortical button fixation and CC ligament reconstruction that resulted in a 100% union rate and excellent clinical outcomes with acceptable complications.

Surgical treatment of vertically unstable lateral clavicle fractures (Neer 2b) with locked plate fixation and coracoclavicular ligament reconstruction

2013 ◽  
Vol 133 (7) ◽  
pp. 935-939 ◽  
Author(s):  
Benedikt Schliemann ◽  
Steffen B. Roßlenbroich ◽  
Kristian N. Schneider ◽  
Wolf Petersen ◽  
Michael J. Raschke ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Ligament Reconstruction ◽  
Plate Fixation ◽  
Coracoclavicular Ligament ◽  
Locked Plate ◽  
Lateral Clavicle ◽  
Coracoclavicular Ligament Reconstruction ◽  
Clavicle Fractures

Biomechanical Evaluation of a Single- Versus Double-Tunnel Coracoclavicular Ligament Reconstruction With Acromioclavicular Stabilization for Acromioclavicular Joint Injuries

2018 ◽  
Vol 46 (5) ◽  
pp. 1070-1076 ◽  
Author(s):  
Michael B. Banffy ◽  
Carlos Uquillas ◽  
Julie A. Neumann ◽  
Neal S. ElAttrache
Keyword(s):  
Ligament Reconstruction ◽  
Ultimate Load ◽  
Clavicle Fracture ◽  
Biomechanical Properties ◽  
Reconstruction Technique ◽  
Ac Joint ◽  
Joint Injuries ◽  
Load To Failure ◽  
Clavicle Fractures ◽  
Ac Joint Injuries

Background: An anatomic double-tunnel (DT) reconstruction technique has been widely adopted to reconstruct the ruptured coracoclavicular (CC) ligaments seen with high-grade acromioclavicular (AC) joint injuries. However, the anatomic DT reconstruction has been associated with the risk of clavicle fractures, which may be problematic, particularly for contact athletes. Purpose/Hypothesis: The purpose was to compare a single-tunnel (ST) CC ligament reconstruction for AC joint injuries with the native state as well as with the more established anatomic DT CC ligament reconstruction. The hypothesis was that ST CC ligament reconstruction would demonstrate biomechanical properties similar to those of the native state and the DT CC ligament reconstruction. Study Design: Controlled laboratory study. Methods: Eighteen fresh-frozen human cadaveric shoulders (9 matched pairs) with mean ± SD age of 55.5 ± 8.5 years underwent biomechanical testing. One specimen of each matched pair underwent a ST CC ligament reconstruction and the second, a DT CC ligament reconstruction. The ST and DT CC ligament reconstruction techniques involved a 5-mm distal clavicle excision, avoided coracoid drilling, and utilized a 3.0-mm suture anchor to fix the excess lateral limb to reconstruct the superior AC joint capsule. The ST CC ligament reconstruction technique additionally included a 1.3-mm suture tape to help avoid a sawing effect, as well as a dog-bone button over the clavicular tunnel to increase stability of the construct. All specimens were tested to 70 N in 3 directions (superior, anterior, and posterior) in the intact and reconstructed states. The ultimate load, yield load, stiffness, and mode of failure of the reconstructed specimens were tested. Results: There were no significant differences in translation at 70 N in the superior ( P = .31), anterior ( P = .56), and posterior ( P = .35) directions between the ST CC ligament reconstruction and the intact state. The ultimate load to failure, yield load, and stiffness in the ST and DT groups were also not significantly different. There were no distal clavicle fractures in load-to-failure testing in the ST or DT group. Conclusion: In this biomechanical study, ST CC ligament reconstruction demonstrates biomechanical properties comparable to the intact state. Additionally, use of the ST CC ligament reconstruction shows biomechanical properties similar to the DT CC ligament reconstruction technique while theoretically posing less risk of clavicle fracture. Clinical Relevance: This study suggests that the ST CC ligament reconstruction has biomechanical properties equivalent to the DT CC ligament reconstruction with less theoretical risk of clavicle fracture.

New Lateral Ligament Reconstruction Approach

2010 ◽  
Vol 44 (8) ◽  
pp. 10
Author(s):  
KERRI WACHTER
Keyword(s):  
Ligament Reconstruction ◽  
Lateral Ligament

Symposium 5: Psychology of pain and sport injuries: Pain and mood following anterior cruciate ligament reconstruction

2003 ◽  
Author(s):  
B. W. Brewer ◽  
A. E. Cornelius ◽  
J. L. Van Raalte ◽  
J. H. Sklar ◽  
J. R. Corsetti ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Sport Injuries ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate
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