Double Endobutton Technique for Repair of Complete Acromioclavicular Joint Dislocations

Struhl, Steven

doi:10.1097/bte.0b013e31815907a3

Cited by 53 publications

(47 citation statements)

References 25 publications

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“…The metallic buttons can withstand forces in excess of 1,150 Newtons [9]. Thus, the strength and stiffness of the device (CL and 5 strands of #2 Ethibond suture) are much greater than that of the native ligament complex [23]. The deforming forces of the weight of the arm are distributed along the surfaces of the two metal endobutton plates and not the suture material itself, which passes through the holes of the endobutton.…”

Section: Discussionmentioning

confidence: 99%

“…The deforming forces of the weight of the arm are distributed along the surfaces of the two metal endobutton plates and not the suture material itself, which passes through the holes of the endobutton. This design prevents the sutures from "slicing" through the clavicle when extreme forces are applied [23]. The low profile of the implant minimizes the chance of soft tissue reaction and eliminates the need for a second operation for removal of the implant.…”

Section: Discussionmentioning

confidence: 99%

“…A 4.0-mm drill was then used to ream over the guide wire. Another drill hole was made 2 cm from the distal end of the clavicle [23]. The position of the medial drill was slightly posterior of the superior surface of the clavicle.…”

Section: Surgical Techniquesmentioning

confidence: 99%

“…1). The sutures were tied on top of the endobutton [23]. The suture tails were brought out of the coracoclavicular space and passed through the lateral drill holes.…”

Section: Surgical Techniquesmentioning

confidence: 99%

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Triple endobuttton technique for the treatment of acute complete acromioclavicular joint dislocations: preliminary results

Wei

Chen

Zeng

et al. 2010

International Orthopaedics (SICOT)

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Numerous procedures have been described for the operative management of acromioclavicular (AC) joint injuries. Some of these techniques, including hardware fixation and non-anatomical reconstructions, are associated with serious complications and high failure rates. Recently, AC joint reconstruction techniques have focused on anatomical restoration of the coracoclavicular ligaments to achieve optimal clinical outcomes. We used a triple endobutton technique to separately reconstruct the trapezoid and the coronoid portions of the coracoclavicular ligament. We evaluated the preliminary clinical and radiological results of this technique in patients with acute complete dislocation of the AC joint. All patients achieved a significant improvement in the pain and function of shoulder at a mean follow-up interval of 12 months (range, 8-14 months). Excellent reduction of the AC joint was maintained. The triple endobutton technique may be safe and effective for the treatment of acute complete AC joint dislocations.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Surgical Techniquesmentioning

confidence: 99%

“…1). The sutures were tied on top of the endobutton [23]. The suture tails were brought out of the coracoclavicular space and passed through the lateral drill holes.…”

Section: Surgical Techniquesmentioning

confidence: 99%

See 2 more Smart Citations

Triple endobuttton technique for the treatment of acute complete acromioclavicular joint dislocations: preliminary results

Wei

Chen

Zeng

et al. 2010

International Orthopaedics (SICOT)

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“…Struhl recently described the EndoButton Closed Loop (CL) (Smith & Nephew, Memphis, TN), which is similar to the TightRope in that it is a nonrigid fixation and reduces the ACJ while also permitting slight motion through the joint [62].…”

Section: Endobutton Closed Loopmentioning

confidence: 98%

Management of the Acromioclavicular Joint Problems

Tetik

2011

Sports Injuries

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The acromioclavicular joint (ACJ) is composed of the distal end of the clavicle and the acromion. Its function is to anchor the clavicle to the scapula and to the shoulder girdle. The subcutaneous location of this joint makes it vulnerable to injury. It is approximately 9% of all the shoulder injuries. The majority of the injuries occur in men with a male to female ratio of approximately 5:1, and patients in their 20s are the most affected age group [53]. Because of the high incidence of these injuries, orthopedists, sports medicine doctors, emergency physicians, and physical therapists should be aware of the management of these injuries [56]. AnatomyThe ACJ is subcutaneous and has little protection by soft tissues. It is composed of the distal end of the clavicle and the acromion and serves to anchor the clavicle to the scapula and the shoulder girdle. This is an inherently unstable articulation. ACJ capsule and the strong coracoclavicular (CC) ligaments, conoid ligament medially and trapezoid ligament laterally, support the joint and provide static stability. The dynamic stabilizers are the trapezius and deltoid muscles. The distal ends of the clavicle and the acromion are lined with hyaline cartilage, and there is a meniscal structure intraarticularly. The role of this meniscus is negligible, and generally it is thought to be degenerated during the fourth decade [56].The clavicular origin of the conoid ligament originates an average of 46 mm medial to the ACJ, and the trapezoid ligament originates 26 mm medial to the ACJ. The conoid is more posterior compared with the trapezoid origin at the mid-portion of the inferior surface of the clavicle [52]. The superior, inferior, and posterior acromioclavicular (AC) ligaments insert an average of 16-20 mm medial to the ACJ on the clavicle. The importance of this anatomic observation is that aggressive distal clavicle excision (DCE) can destabilize the ACJ and lead to symptomatic posterior impingement against the acromion if that ranges were exceeded.

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