Biomechanics and comparison of two operative methods of treatment of complete acromioclavicular separation

Sixty-three complete acromioclavicular separations were treated by 2 operative methods. Acromioclavicular wiring gave 73% acceptable results while wire or Dacron coracoclavicular loop gave 94% acceptable results. Complications, especially broken, bent, or backed-out wires were common with acromioclavicular wiring. Of 44 patients treated by acromioclavicular wiring, 5 required late distal clavicle resection and 4 of these had retained menisci. Loop fixation is mechanically superior since the loop is in the direction of the tensile forces. In acromioclavicular wiring, however, the fixation Kirschner wires are subjected to high bending moments. Loop fixation avoids violation of the acromioclavicular joint but does not restrict rotation of the clavicle. The operation is simple to perform and postoperative immobilization is minimal. Woven Dacron may be superior to surgical wire for loop fixation in that unlike wire it does not require removal by a second operation. Woven Dacron may also stimulate coracoclavicular ligament reconstitution.