Shoulder: Trauma

Method of Subcoracoid Graft Passage in Acromioclavicular Joint Reconstruction

George MS, Jorgensen JR (KSF Orthopaedic Ctr, Houston, TX) Orthopedics 33:812, 2010^§

Abstract

Background

Surgical reconstruction is recommended for the treatment of severe acromioclavicular separation type IV and V injuries as well as symptomatic type III injuries that have not resolved with nonoperative approaches. Several surgical techniques can be used, including primary ligament repair, modified Weaver-Dunn reconstruction, and free soft tissue transfer passed either through or around the coracoid process. Reconstruction using free soft tissue grafts passed around the coracoid process is more biomechanically stable than modified Weaver-Dunn reconstruction. Passing the suture and/or graft material under the coracoid process is the most technically demanding aspect of this approach because of limited exposure, proximity to neurovascular structures, width of the conjoined tendon, and thickness of fascia adjacent to the coracoid process. The 45° Suture Lasso offers the surgeon a readily available, appropriately curved, and sharp tool to pass sutures and/or soft tissue grafts safely, simply, and efficiently.

Methods

Six patients (mean age 41 years) with chronic type V acromioclavicular separation had reconstruction with semitendinosus allograft using the Suture Lasso to pass the graft under the coracoid process. Follow-up was a minimum of 6 months, with postoperative radiographs obtained 2 weeks after surgery.

Technique

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