Triple endobutton technique in acromioclavicular joint reduction and reconstruction

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomedical Engineering

Background:

• Acromioclavicular joint (ACJ) dislocations are common, particularly in young athletes across various sports.
• High-grade ACJ injuries often necessitate surgical intervention for athletes to resume their athletic activities.
• Current surgical management aims to restore joint stability and facilitate a return to sport.

Purpose of the Study:

• To present a novel surgical technique for reducing and maintaining the coracoclavicular interval in ACJ dislocations.
• To evaluate the safety and efficacy of a new low-profile metallic button fixation system for ACJ injuries.

Main Methods:

• A new fixation technique utilizing three low-profile metallic buttons and suture material is described.
• The technique involves placing two buttons on the clavicle and one on the coracoid for coracoclavicular stabilization.
• This method provides non-rigid fixation, allowing joint movement while maintaining reduction.

Main Results:

• The technique was applied to 5 patients, demonstrating strong intraoperative fixation.
• Postoperative radiographs at immediate, 2 weeks, and 6 months showed excellent reduction of the coracoclavicular interval and AC joint.
• The implant design ensures stability against cyclic loading and eliminates the need for removal.

Conclusions:

• The described metallic button fixation technique for ACJ dislocations is safe and effective in the short term.
• This method provides robust fixation, superior to native ligament strength, with the potential for long-term stability.
• The low-profile design and inherent strength make it a viable option for managing ACJ injuries in athletes.