Pediatric AC Joint Fracture Dislocation: Arthroscopy-assisted Reduction and Internal Bracing

Acromioclavicular joint injuries are common injuries around shoulder and comprise around 9-12% and are rare in pediatric population. Many surgeries have been described which include open stabilization, arthroscopic assisted, or complete arthroscopic. We describe our technique of arthroscopic-assisted fixation in AC joint acute injuries, in which we arthroscopically pass fiber tape and tunnels across coracoid base and clavicle to stabilize the upward forces, followed by double breasting for AC joint with fiber tape to balance the horizontal forces.

A 9-year-old female kid with a history of falls with left shoulder pain and diagnosed with fracture dislocation of the left ac joint. The patient in beach chair position. Arthroscopically, fibertape was passed through a drill hole near to cc ligament and cinch loop was done through it and around coracoid. With a mini-incision, AC joint further stabilized.

Similar case reports are very few and arthroscopic management of same is nearly none. Advantages of our procedure are relatively low cost of the implant, and no anchors or metal implants at AC joint to avoid impingement. Open AC joint stabilization addresses the disc in joint. Disadvantages are a long learning curve.