Percutaneous cannulated screw coracoclavicular fixation for acute acromioclavicular dislocations.
In 1941, Bosworth introduced a new method of repairing acute complete acromioclavicular dislocations in which a noncannulated coracoclavicular lag-screw was inserted by a blind technique. The author reintroduces the percutaneous coracoclavicular fixation concept. A cannulated screw was specially designed, and the technique of percutaneous insertion under fluoroscopic image control was developed. Fifty-three acromioclavicular dislocations were treated by this method. There were 40 Type III, five Type IV, and three Type V dislocations with distal clavicle fractures in conjunction with complete coracoclavicular ligament tears. Technical failures, which occurred in 17 of 53 patients (32%) included: failed percutaneous insertion in two; early screw pullout in three; late screw pullout in four; subluxation after screw removal in six; and malreduction of Type IV dislocation in two. There was no screw breakage or evidence of migration. Serous drainage occurred in two patients.
Tsou
P M
PM
Division of Orthopaedic Surgery, University of California, Los Angeles.
D000173:Acromioclavicular Joint / Q000293:injuries / Q000601:surgery*; D000208:Acute Disease; D000328:Adult; D001858:Bone Nails; D001863:Bone Screws / Q000009:adverse effects; D002968:Clavicle / Q000293:injuries; D005260:Female; D005592:Fracture Fixation / Q000295:instrumentation / Q000379:methods; D005596:Fractures, Closed / Q000601:surgery; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications