Modified Internal Fixation Technique for Acromio-Clavicular (AC) joint dislocation: The “Hidden Knot Technique”

Abstract

Acromioclavicular (AC) joint injuries are common and often seen in contact athletes, resulting from a fall on the shoulder<br />tip with adducted arm. This joint is stabilized by both static and dynamic structures including the coracoclavicular (CC)<br />ligament. Most reconstruction techniques focus on CC ligament augmentation as the primary stabilizer of the AC joint.<br />The best surgical technique for some AC joint dislocations is still controversial. In this study, we explained a modification<br />of the CC ligament reconstruction technique described by Wellmann. The method is based on minimally invasive CC<br />ligament augmentation with a flip button/polydioxanone (PDS) repair, typically used for extracortical ACL graft fixation.<br />Patients commonly complain that heavy sutures under the skin in subcutaneous tissue irritate the skin and sometimes<br />require reoperation for suture removal. We present an augmentation technique that resolves this issue by changing the<br />suture knot location to the sub-clavicular position.