A New Technique for Solving Tightrope Cutout during Acromioclavicular Joint Fixation: A Case Report
- Author:
Ng BW
;
Abdullah AF
;
Nadarajah S
- Publication Type:Case Reports
- Keywords:
TightRope cutout;
clavicle fracture;
ACJ disruption;
TightRope on tubular plate
- MeSH:
Acromioclavicular Joint
- From:Malaysian Orthopaedic Journal
2017;11(1):57-59
- CountryMalaysia
- Language:English
-
Abstract:
Acromioclavicular joint (ACJ) dissociation is one of the
common injuries affecting adults. The stability of ACJ
largely depends on the integrity of acromioclavicular
ligament, coracoclavicular ligament, capsule, trapezius
muscle and deltoid muscle. The injury has been classified by
Rockwood into six types and treatment options can be
guided by the classification. TightRope fixation is one of the
many surgical procedures available to address
acromioclavicular joint separation. It consists of tensioning
of a no. 5 Fibrewire suture secured at both ends to lowprofile
metallic buttons. Despite various advantages of using
this technique, complications such as suture cut-out, clavicle
fracture and suture failure have been documented. The
author presents a case of a type III acromioclavicular joint
dissociation treated with TightRope which suture cutout was
noted intra-operatively. Decision to amend the fixation using
a cut one-third tubular plate as an additional anchor for the
metallic button on the clavicle was made. Patient’s progress
was evaluated using the University of California at Los
Angeles Shoulder Score (UCLA Shoulder Score) and
significant improvement was noted six months post
operatively. We propose this technique as a solution to the
encountered problem.
- Full text:P020170413532264930604.pdf
