Functional outcome following coracoclavicular ligament reconstruction using a gracilis tendon graft for acute type III acromioclavicular dislocation: a case report

Authors

  • Made Tusan Sidharta Department of Orthopaedic and Traumatology, Sanglah General Hospital, Udayana University, Bali, Indonesia
  • I. Gusti Ngurah Wien Aryana Department of Orthopaedic and Traumatology, Sanglah General Hospital, Udayana University, Bali, Indonesia
  • Ida Bagus Gede Arimbawa Department of Orthopaedic and Traumatology, Sanglah General Hospital, Udayana University, Bali, Indonesia

DOI:

https://doi.org/10.18203/2320-6012.ijrms20183280

Keywords:

Acromioclavicular (AC) joint, Constant score, Gracilis tendon

Abstract

The acromioclavicular joint is stabilized by two ligaments: the acromioclavicular ligaments and coracoclavicular ligaments. AC joint dislocations account for 9% to 10% of all shoulder injuries. Tossy and Allman classified acromioclavicular dislocations into three types (I, II and III). This classification was modified by Rockwood (types IV, V, and VI). Type I and II dislocations are treated conservatively. Surgery is indicated for certain Rockwood type III and for all type IV, V, and VI injuries. A 45 years old man yoga trainer presented to our emergency department with a chief complaint of pain over his left shoulder after had traffic accident 3 hours prior to admission. Physical examination revealed left lateral clavicular end prominent and tenderness over the left shoulder with limited range of motion due to pain. A Zanca view X-Ray of left shoulder was performed and revealed dislocation of acromioclavicular joint. The patient was diagnosed with suspect Left AC joint disruption grade III. We performed coracoclavicular ligament reconstruction using a gracilis tendon graft 2 days after the accident. Before the surgery, constant score of the patient left shoulder was 25 (Fair). The constant score measured was 63 after 10 month follow up. Coracoclavicular ligament reconstruction with an autogenous gracilis tendon graft was feasible and safe in physically active patients with acute type-III acromioclavicular joint dislocation.

References

Law KY, Yung SH, Ho PY, Chang HT, Chan KM. Coracoclavicular ligament reconstruction using a gracilis tendon graft for acute type-III acromioclavicular dislocation. J Ortho Surg. 2007 Dec;15(3):315-8.

Zhu Y, Hsueh P, Zeng B, Chai Y, Zhang C, Chen Y, et al. A prospective study of coracoclavicular ligament reconstruction with autogenous peroneus longus tendon for acromioclavicular joint dislocations. J shoulder and elbow surgery. 2018;27(6):e178-88.

Larsen EI, Bjerg-Nielsen AR, Christensen PO. Conservative or surgical treatment of acromioclavicular dislocation. A prospective, controlled, randomized study. J Bone Joint Surgery. American volume. 1986 Apr;68(4):552-5.

Larsen E, Hede A. Treatment of acute acromioclavicular dislocation. Three different methods of treatment prospectively studied. Acta orthopaedica belgica. 1987;53(4):480-4.

Habernek H, Weinstabl R, Schmid L, Fialka C. A crook plate for treatment of acromioclavicular joint separation: indication, technique, and results after one year. J trauma. 1993 Dec;35(6):893-901.

Pavlik A, Csépai D, Hidas P. Surgical treatment of chronic acromioclavicular joint dislocation by modified Weaver-Dunn procedure. Knee Surgery, Sports Traumatology, Arthroscopy. 2001 Sep 1;9(5):307-12.

Jones HP, Lemos MJ, Schepsis AA. Salvage of failed acromioclavicular joint reconstruction using autogenous semitendinosus tendon from the knee: surgical technique and case report. Am J Spo Med. 2001 Mar;29(2):234-7.

Tienen TG, Oyen JF, Eggen PJ. A modified technique of reconstruction for complete acromioclavicular dislocation: a prospective study. Ame J sports medicine. 2003 Sep;31(5):655-9.

Hegazy G, Safwat H, Seddik M, Al-shal EA, Al-Sebai I, Negm M. Modified Weaver-Dunn procedure versus the use of semitendinosus autogenous tendon graft for acromioclavicular joint reconstruction. Open orthopaedics J. 2016;10:166.

Esenyel CZ, Ozturk K, Bulbul M, Ayanoglu S, Ceylan HH. Coracoclavicular ligament repair and screw fixation in acromioclavicular dislocations. Acta Orthop Traumatol Turc. 2010 May 1;44(3):194-8.

Johansen JA, Grutter PW, McFarland EG, Petersen SA. Acromioclavicular joint injuries: indications for treatment and treatment options. J Shoulder Elbow Surg. 2011 Mar 1;20(2):S70-82.

Li X, Ma R, Bedi A, Dines DM, Altchek DW, Dines JS. Management of acromioclavicular joint injuries. JBJS. 2014 Jan 1;96(1):73-84.

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Published

2018-07-25

How to Cite

Sidharta, M. T., Wien Aryana, I. G. N., & Arimbawa, I. B. G. (2018). Functional outcome following coracoclavicular ligament reconstruction using a gracilis tendon graft for acute type III acromioclavicular dislocation: a case report. International Journal of Research in Medical Sciences, 6(8), 2836–2840. https://doi.org/10.18203/2320-6012.ijrms20183280

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Section

Case Reports