Stabilization of the clavicle after distal resection: a biomechanical study.
BACKGROUND
The potential destabilizing effect of distal clavicle resection has received limited attention.


OBJECTIVE
Suturing the coracoacromial ligament to the undersurface of the distal clavicle after resection could counter clavicle instability.


METHODS
Controlled laboratory study.


METHODS
The effect of ligament augmentation on posterior translation of the clavicle after resection was evaluated using 12 fresh-frozen cadaveric shoulders. Posterior clavicular displacement was measured after the application of a 70-N load under 4 different conditions: (1) the intact joint, (2) after distal clavicle resection, (3) clavicle resection plus acromioclavicular capsular ligament repair, and (4) clavicle resection plus acromioclavicular capsular ligament repair plus coracoacromial ligament augmentation.


RESULTS
Mean displacements for each of the test conditions were as follows: (1) 5.60 mm, (2) 7.38 mm, (3) 7.54 mm, and (4) 6.34 mm. A 32% increase in posterior translation was measured after resection compared to the intact specimen. No reduction in posterior displacement was noted after capsular repair; however, displacement decreased significantly when capsular repair was coupled with ligament augmentation.


CONCLUSIONS
Results suggest that the destabilizing effect of clavicle resection can be partially countered by the proposed ligament augmentation.


CONCLUSIONS
That the destabilizing effect of clavicle resection can be partially countered by the proposed ligament augmentation may be particularly relevant in cases of resection for posttraumatic arthritis after acromioclavicular separation in which some degree of preexisting acromioclavicular capsular attenuation and consequently acromioclavicular joint laxity may be presumed.
Corteen
Darren P
DP
Department of Orthopedic Surgery, Wayne State University, Detroit, Michigan 48071, USA.
Teitge
Robert A
RA
D000173:Acromioclavicular Joint / Q000601:surgery*; D000368:Aged; D001696:Biomechanical Phenomena; D002102:Cadaver; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D008022:Ligaments / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012785:Shoulder Joint / Q000502:physiology; D013536:Suture Techniques