Skip to main content
Erschienen in: Clinical Orthopaedics and Related Research® 1/2010

01.01.2010 | Surgical Technique

Luggage Tag Technique of Anatomic Fixation of Displaced Acromioclavicular Joint Separations

verfasst von: Keith Baldwin, MD, MPH, MSPT, Surena Namdari, MD, MSc, Jaron R. Andersen, MD, Brian Lee, BS, John M. Itamura, MD, G. Russell Huffman, MD, MPH

Erschienen in: Clinical Orthopaedics and Related Research® | Ausgabe 1/2010

Einloggen, um Zugang zu erhalten

Abstract

Acromioclavicular joint dislocations are common injuries in active individuals. Most of these injuries may be treated nonoperatively. However, many techniques have been described when surgical management is warranted. A recent biomechanical study favors anatomic reconstruction of the conoid and trapezoid ligaments and the acromioclavicular joint capsule, as opposed to the traditional technique of excision of the lateral end of clavicle and transfer of the coracoacromial ligament to the intramedullary canal of the distal clavicle. We present a modification of the anatomic fixation technique using a luggage tag method, which places a graft under the base of the coracoid. This procedure has been associated with few redisplacements of the distal clavicle, reliable pain relief, and minimal postoperative morbidity. We found the luggage tag technique provides anatomic fixation of the distal clavicle and restoration of coronal and sagittal plane stability to the injured acromioclavicular joint. This procedure should reduce the possibility of coracoid fracture and decreases the risk of hardware complications associated with reconstruction techniques that violate the base of the coracoid process.
Level of Evidence: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Literatur
1.
Zurück zum Zitat Adachi K, Yagi H, Futami T, Tsukamoto M. Surgical treatment of acromioclavicular dislocation by coracoacromial ligament transfer. J Orthop Surg. 1996;4:7–11. Adachi K, Yagi H, Futami T, Tsukamoto M. Surgical treatment of acromioclavicular dislocation by coracoacromial ligament transfer. J Orthop Surg. 1996;4:7–11.
2.
Zurück zum Zitat Adam FF, Farouk O. Surgical treatment of chronic complete acromioclavicular dislocation. Int Orthop. 2004;28:119–122.CrossRefPubMed Adam FF, Farouk O. Surgical treatment of chronic complete acromioclavicular dislocation. Int Orthop. 2004;28:119–122.CrossRefPubMed
3.
Zurück zum Zitat Bannister GC, Wallace WA, Stableforth PG, Hutson MA. The management of acute acromioclavicular dislocation: a randomized prospective controlled trial. J Bone Joint Surg Br. 1989;71:848–850.PubMed Bannister GC, Wallace WA, Stableforth PG, Hutson MA. The management of acute acromioclavicular dislocation: a randomized prospective controlled trial. J Bone Joint Surg Br. 1989;71:848–850.PubMed
4.
Zurück zum Zitat Beaton DE, Davis AM, Hudak P, McConnell S. The DASH (Disabilities of the Arm, Shoulder and Hand) Outcome Measure: what do we know about it now? Br J Hand Ther. 2001;6:109–118. Beaton DE, Davis AM, Hudak P, McConnell S. The DASH (Disabilities of the Arm, Shoulder and Hand) Outcome Measure: what do we know about it now? Br J Hand Ther. 2001;6:109–118.
5.
Zurück zum Zitat Cadenat F. The treatment of dislocations and fractures of the outer end of the clavicle. Int Clin. 1917;1:145–169. Cadenat F. The treatment of dislocations and fractures of the outer end of the clavicle. Int Clin. 1917;1:145–169.
6.
Zurück zum Zitat Cox JS. The fate of the acromioclavicular joint in athletic injuries. Am J Sports Med. 1981;9:50–53.CrossRefPubMed Cox JS. The fate of the acromioclavicular joint in athletic injuries. Am J Sports Med. 1981;9:50–53.CrossRefPubMed
7.
Zurück zum Zitat Dawe CJ. Acromioclavicular joint injuries. J Bone Joint Surg Br. 1980;62:269. Dawe CJ. Acromioclavicular joint injuries. J Bone Joint Surg Br. 1980;62:269.
8.
Zurück zum Zitat Dias JJ, Steingold RF, Richardson RA, Tesfayohannes B, Gregg PJ. The conservative treatment of acromioclavicular dislocation review after five years. J Bone Joint Surg Br. 1987;69:719–722.PubMed Dias JJ, Steingold RF, Richardson RA, Tesfayohannes B, Gregg PJ. The conservative treatment of acromioclavicular dislocation review after five years. J Bone Joint Surg Br. 1987;69:719–722.PubMed
9.
Zurück zum Zitat Dumontier C, Sautet A, Man M, Apoil A. Acromioclavicular dislocations: treatment by coracoacromial ligamentoplasty. J Shoulder Elbow Surg. 1995;4:130–134.CrossRefPubMed Dumontier C, Sautet A, Man M, Apoil A. Acromioclavicular dislocations: treatment by coracoacromial ligamentoplasty. J Shoulder Elbow Surg. 1995;4:130–134.CrossRefPubMed
10.
Zurück zum Zitat Godfrey J, Hamman R, Lowenstein S, Briggs K, Kocher M. Reliability, validity, and responsiveness of the simple shoulder test: psychometric properties by age and injury type. J Shoulder Elbow Surg. 2007;16:260–267.CrossRefPubMed Godfrey J, Hamman R, Lowenstein S, Briggs K, Kocher M. Reliability, validity, and responsiveness of the simple shoulder test: psychometric properties by age and injury type. J Shoulder Elbow Surg. 2007;16:260–267.CrossRefPubMed
11.
Zurück zum Zitat Guy DK, Wirth MA, Griffin JL, Rockwood CA Jr. Reconstruction of chronic and complete dislocations of the acromioclavicular joint. Clin Orthop Relat Res. 1998;347:138–149.CrossRefPubMed Guy DK, Wirth MA, Griffin JL, Rockwood CA Jr. Reconstruction of chronic and complete dislocations of the acromioclavicular joint. Clin Orthop Relat Res. 1998;347:138–149.CrossRefPubMed
12.
Zurück zum Zitat Jari R, Costic RS, Rodosky MW, Debski RE. Biomechanical function of surgical procedures for acromioclavicular joint dislocation. Arthroscopy. 2004;20:237–245.PubMed Jari R, Costic RS, Rodosky MW, Debski RE. Biomechanical function of surgical procedures for acromioclavicular joint dislocation. Arthroscopy. 2004;20:237–245.PubMed
13.
Zurück zum Zitat Jester A, Harth A, Germann G. Measuring levels of upper-extremity disability in employed adults using the DASH Questionnaire. J Hand Surg Am. 2005;30:1074.e1–1074.e10. Jester A, Harth A, Germann G. Measuring levels of upper-extremity disability in employed adults using the DASH Questionnaire. J Hand Surg Am. 2005;30:1074.e1–1074.e10.
14.
Zurück zum Zitat Karisson J, Arnarson H, Sigurjonsson K. Acromioclavicular dislocations treatment by coracoacromial ligament transfer. Arch Orthop Trauma Surg. 1986;106:8–11.CrossRef Karisson J, Arnarson H, Sigurjonsson K. Acromioclavicular dislocations treatment by coracoacromial ligament transfer. Arch Orthop Trauma Surg. 1986;106:8–11.CrossRef
15.
Zurück zum Zitat Kawabe N, Watanabe R, Sato M. Treatment of complete acromioclavicular separation by coracoacromial ligament transfer. Clin Orthop Relat Res. 1984;185:222–227.PubMed Kawabe N, Watanabe R, Sato M. Treatment of complete acromioclavicular separation by coracoacromial ligament transfer. Clin Orthop Relat Res. 1984;185:222–227.PubMed
16.
Zurück zum Zitat Kennedy JC, Cameron H. Complete dislocation of the acromioclavicular joint. J Bone Joint Surg Br. 1954;36:202–208.PubMed Kennedy JC, Cameron H. Complete dislocation of the acromioclavicular joint. J Bone Joint Surg Br. 1954;36:202–208.PubMed
17.
Zurück zum Zitat Klimkiewicz JJ, Williams GR, Sher JS, Karduna A, Dex Jardins J, Iannotti JP. The acromioclavicular capsule as a restraint to posterior translation of the clavicle: a biomechanical analysis. J Shoulder Elbow Surg. 1999;8:119–124.CrossRefPubMed Klimkiewicz JJ, Williams GR, Sher JS, Karduna A, Dex Jardins J, Iannotti JP. The acromioclavicular capsule as a restraint to posterior translation of the clavicle: a biomechanical analysis. J Shoulder Elbow Surg. 1999;8:119–124.CrossRefPubMed
18.
Zurück zum Zitat Krackow KA, Thomas SC, Jones LC. A new stitch for ligament-tendon fixation. J Bone Joint Surg Am.1986;68:764–766.PubMed Krackow KA, Thomas SC, Jones LC. A new stitch for ligament-tendon fixation. J Bone Joint Surg Am.1986;68:764–766.PubMed
19.
Zurück zum Zitat Kumar S, Sethi A, Jain AK. Surgical treatment of complete acromioclavicular dislocation using the coracoacromial ligament and coracoclavicular fixation: report of a technique in 14 patients. J Orthop Trauma. 1995;9:507–510.CrossRefPubMed Kumar S, Sethi A, Jain AK. Surgical treatment of complete acromioclavicular dislocation using the coracoacromial ligament and coracoclavicular fixation: report of a technique in 14 patients. J Orthop Trauma. 1995;9:507–510.CrossRefPubMed
20.
Zurück zum Zitat Kutschera HP, Kotz RI. Bone-ligament transfer of coracoacromial ligament for acromioclavicular dislocation: a new fixation method used in 6 cases. Acta Orthop Scand. 1997;68:246–248.PubMedCrossRef Kutschera HP, Kotz RI. Bone-ligament transfer of coracoacromial ligament for acromioclavicular dislocation: a new fixation method used in 6 cases. Acta Orthop Scand. 1997;68:246–248.PubMedCrossRef
21.
Zurück zum Zitat Lancaster S, Horowitz M, Alonso J. Complete acromioclavicular separations: a comparison of operative methods. Clin Orthop Relat Res. 1987;216:80–88.PubMed Lancaster S, Horowitz M, Alonso J. Complete acromioclavicular separations: a comparison of operative methods. Clin Orthop Relat Res. 1987;216:80–88.PubMed
22.
Zurück zum Zitat Larsen E, Petersen V. Operative treatment of chronic acromioclavicular dislocation. Injury. 1987;18:55–56.CrossRefPubMed Larsen E, Petersen V. Operative treatment of chronic acromioclavicular dislocation. Injury. 1987;18:55–56.CrossRefPubMed
23.
Zurück zum Zitat Lupo R, Rapisarda S. Variations in method in the use of the coracoacromial ligament for the surgical treatment of acromioclavicular dislocations. Chir Organi Mov. 2000;85:293–301.PubMed Lupo R, Rapisarda S. Variations in method in the use of the coracoacromial ligament for the surgical treatment of acromioclavicular dislocations. Chir Organi Mov. 2000;85:293–301.PubMed
24.
Zurück zum Zitat Mazzocca AD, Santangelo SA, Johnson ST, Rios CG, Dumonski ML, Arciero RA. A biomechanical evaluation of an anatomical coracoclavicular ligament reconstruction. Am J Sports Med. 2006;34:236–246.CrossRefPubMed Mazzocca AD, Santangelo SA, Johnson ST, Rios CG, Dumonski ML, Arciero RA. A biomechanical evaluation of an anatomical coracoclavicular ligament reconstruction. Am J Sports Med. 2006;34:236–246.CrossRefPubMed
25.
Zurück zum Zitat Pavlik A, Csepai D, Hidas P. Surgical treatment of chronic acromioclavicular dislocation by modified Weaver-Dunn procedure. Knee Surg Sports Traumatol Arthrosc. 2001;9:307–312.CrossRefPubMed Pavlik A, Csepai D, Hidas P. Surgical treatment of chronic acromioclavicular dislocation by modified Weaver-Dunn procedure. Knee Surg Sports Traumatol Arthrosc. 2001;9:307–312.CrossRefPubMed
26.
Zurück zum Zitat Press J, Zuckerman JD, Gallagher M, Cuomo F. Treatment of grade III acromioclavicular separations: operative versus nonoperative management. Bull Hosp Jt Dis. 1997;56:77–83.PubMed Press J, Zuckerman JD, Gallagher M, Cuomo F. Treatment of grade III acromioclavicular separations: operative versus nonoperative management. Bull Hosp Jt Dis. 1997;56:77–83.PubMed
27.
Zurück zum Zitat Rauschning W, Nordesjö LO, Nordgren B, Sahlstedt B, Wigren A. Resection arthroplasty for repair of complete acromioclavicular separations. Arch Orthop Trauma Surg. 1980;97:161–164.CrossRefPubMed Rauschning W, Nordesjö LO, Nordgren B, Sahlstedt B, Wigren A. Resection arthroplasty for repair of complete acromioclavicular separations. Arch Orthop Trauma Surg. 1980;97:161–164.CrossRefPubMed
28.
Zurück zum Zitat Rockwood CA, Green DP, Bucholz RW. Rockwood and Green’s Fractures in Adults. Ed 3. Philadelphia, PA: JP Lippincott Co; 1991:1186–1199. Rockwood CA, Green DP, Bucholz RW. Rockwood and Green’s Fractures in Adults. Ed 3. Philadelphia, PA: JP Lippincott Co; 1991:1186–1199.
29.
Zurück zum Zitat Shoji H, Roth C, Chuinard R. Bone block transfer of coracoacromial ligament in acromioclavicular injury. Clin Orthop Relat Res. 1986;208:272–277.PubMed Shoji H, Roth C, Chuinard R. Bone block transfer of coracoacromial ligament in acromioclavicular injury. Clin Orthop Relat Res. 1986;208:272–277.PubMed
30.
Zurück zum Zitat Sood A, Wallwork N, Bain IG. Clinical results of coracoacromial ligament transfer in acromioclavicular dislocations: a review of published literature. Int J Shoulder Surg. 2008;2:13–20.CrossRef Sood A, Wallwork N, Bain IG. Clinical results of coracoacromial ligament transfer in acromioclavicular dislocations: a review of published literature. Int J Shoulder Surg. 2008;2:13–20.CrossRef
31.
Zurück zum Zitat Tienen TG, Oyen JF, Eggen PJ. A modified technique of reconstruction for complete acromioclavicular dislocation: a prospective study. Am J Sports Med. 2003;31:655–659.PubMed Tienen TG, Oyen JF, Eggen PJ. A modified technique of reconstruction for complete acromioclavicular dislocation: a prospective study. Am J Sports Med. 2003;31:655–659.PubMed
32.
Zurück zum Zitat Virata SR, Holekamp NM, Meredith TA. “Luggage-tag” suture fixation of partially dislocated intraocular lenses. Ophthalmic Surg Lasers. 2001;32:346–348.PubMed Virata SR, Holekamp NM, Meredith TA. “Luggage-tag” suture fixation of partially dislocated intraocular lenses. Ophthalmic Surg Lasers. 2001;32:346–348.PubMed
33.
Zurück zum Zitat Warren-Smith CD, Ward MW. Operation for acromioclavicular dislocation: a review of 29 cases treated by one method. J Bone Joint Surg Br. 1987;69:715–718.PubMed Warren-Smith CD, Ward MW. Operation for acromioclavicular dislocation: a review of 29 cases treated by one method. J Bone Joint Surg Br. 1987;69:715–718.PubMed
34.
Zurück zum Zitat Weaver JK, Dunn HK. Treatment of acromioclavicular injuries especially complete acromioclavicular separation. J Bone Joint Surg Am. 1972;54:1187–1194.PubMed Weaver JK, Dunn HK. Treatment of acromioclavicular injuries especially complete acromioclavicular separation. J Bone Joint Surg Am. 1972;54:1187–1194.PubMed
35.
Zurück zum Zitat Weinstein DM. Surgical treatment of complete acromioclavicular dislocations. Am J Sports Med. 1995;23:324–331.CrossRefPubMed Weinstein DM. Surgical treatment of complete acromioclavicular dislocations. Am J Sports Med. 1995;23:324–331.CrossRefPubMed
Metadaten
Titel
Luggage Tag Technique of Anatomic Fixation of Displaced Acromioclavicular Joint Separations
verfasst von
Keith Baldwin, MD, MPH, MSPT
Surena Namdari, MD, MSc
Jaron R. Andersen, MD
Brian Lee, BS
John M. Itamura, MD
G. Russell Huffman, MD, MPH
Publikationsdatum
01.01.2010
Verlag
Springer-Verlag
Erschienen in
Clinical Orthopaedics and Related Research® / Ausgabe 1/2010
Print ISSN: 0009-921X
Elektronische ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-009-0877-8

Weitere Artikel der Ausgabe 1/2010

Clinical Orthopaedics and Related Research® 1/2010 Zur Ausgabe

Symposium: Papers Presented at the Annual Meetings of the Knee Society

Does Bearing Design Influence Midterm Survivorship of Unicompartmental Arthroplasty?

Symposium: Papers Presented at the Annual Meetings of the Knee Society

Biographical Sketch: Nathaniel Allison, 1876–1932

Symposium: Papers Presented at the Annual Meetings of the Knee Society

Papers Presented at the Annual Meetings of the Knee Society: Editorial Comment

Symposium: Papers Presented at the Annual Meetings of the Knee Society

Gap Balancing versus Measured Resection Technique for Total Knee Arthroplasty

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Klinikreform soll zehntausende Menschenleben retten

15.05.2024 Klinik aktuell Nachrichten

Gesundheitsminister Lauterbach hat die vom Bundeskabinett beschlossene Klinikreform verteidigt. Kritik an den Plänen kommt vom Marburger Bund. Und in den Ländern wird über den Gang zum Vermittlungsausschuss spekuliert.

TEP mit Roboterhilfe führt nicht zu größerer Zufriedenheit

15.05.2024 Knie-TEP Nachrichten

Der Einsatz von Operationsrobotern für den Einbau von Totalendoprothesen des Kniegelenks hat die Präzision der Eingriffe erhöht. Für die postoperative Zufriedenheit der Patienten scheint das aber unerheblich zu sein, wie eine Studie zeigt.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.