title: Assessment of clavicular translation after arthroscopic Mumford procedure: direct versus indirect resection--a cadaveric study.
abstract: OBJECTIVE
  To compare the horizontal stability of the distal clavicle following arthroscopic resection of its lateral end by direct and indirect techniques.
  
  
  METHODS
  Biomechanical test of cadaveric specimens.
  
  
  METHODS
  We performed arthroscopic distal clavicle resection on 12 fresh-frozen human cadaveric shoulders using direct (group 1, n = 6) or indirect (group 2, n = 6) approaches. In both groups 5 mm of distal clavicle were resected using an arthroscopic burr. The specimens were mounted on a materials testing device that allowed translation of the clavicle along the anteroposterior axis. The degree of posterior translation was measured from maximum anterior displacement of the clavicle.
  
  
  RESULTS
  Mean posterior translation was 19.4 mm (range, 18 to 23 mm; SD, 2.2) and 21.3 mm (range, 18 to 25 mm; SD, 3.1) for groups 1 and 2, respectively. This difference was not statistically significant ( P = .27).
  
  
  CONCLUSIONS
  This study suggests that there is no significant difference in anteroposterior stability of the clavicle following arthroscopic distal clavicle resection with either a direct or indirect approach.
  
  
  CONCLUSIONS
  Clinically, this study addresses concerns about increased potential instability associated with the indirect technique of distal clavicle resection. From a biomechanical standpoint, based on this study, there is no concern for increased instability with the indirect technique of distal clavicle resection compared to a direct technique.
authors.affiliation: Department of Orthopaedic Surgery, New York University-Hospital for Joint Diseases, New York, New York 10003, USA.
authors.forename: Craig A
authors.initials: CA
authors.lastname: Miller
authors.forename: Bernard C
authors.initials: BC
authors.lastname: Ong
authors.forename: Laith M
authors.initials: LM
authors.lastname: Jazrawi
authors.forename: Thomas
authors.initials: T
authors.lastname: Joseph
authors.forename: Christian S
authors.initials: CS
authors.lastname: Heywood
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Rosen
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Rokito
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001182:Arthroscopy / Q000379:methods*; D001696:Biomechanical Phenomena; D002102:Cadaver; D002968:Clavicle / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods; D016059:Range of Motion, Articular; D012785:Shoulder Joint / Q000601:surgery*