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.
Acromioclavicular Joint

sensitivity and specificity of nerve root sedimentation sign(NRS) in our populations. The NRS is a radiological sign todiagnose lumbar spinal stenosis (LSS). It is claimed to bereliable with high sensitivity and specificity. MaterialsandMethods:A total of 82 MRI images from 43patients in Group A (LSS) and 39 patients in Group B (nonLSS) were analysed and compared for the presence of theNRS sign. Two assessors were used to evaluate intra andinter-assessor reliability of this sign based on 56 (33 patients,Group A and 23 patients, Group B). The findings werestatistically analysed using SPSS software. Results:There was a significant association between spinalclaudication and leg numbness with LSS (p<0.001 andKappa=0.857, p<0.001). The inter-assessor reliability wasalso good (Kappa of 0.786, p<0.001).Conclusion:The NRS sign has high sensitivity andspecificity for diagnosing LSS. The sign also has good intraand inter-assessor reliability.