An operative repair of acromioclavicular separation

Sixteen patients underwent an open reduction for complete acromioclavicular separation with a loop of woven Dacron arterial graft. This technique of internal fixation permits an early range of shoulder motion and eliminates the need for a second procedure to remove wire or pins. Experience in vascular reconstruction suggests that fibroblastic ingrowth might occur to substitute for the disrupted ligament complex. All but two of the 16 patients showed excellent results: full restoration of shoulder function, satisfactory cosmesis, and complete relief of pain. One required reoperation for an improperly placed loop, and one had definite over-reduction of the clavicle on the acromion but remained asymptomatic. In several, X-rays showed evidence of pressure resorption and periosteal new-bone formation along the clavicle at the site of the loop, but no loss of fixation. This approach was used successfully in acute trauma and as late as one year following injury.