Assessment of clavicular translation after arthroscopic Mumford procedure: direct versus indirect resection--a cadaveric study.
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.
Miller
Craig A
CA
Department of Orthopaedic Surgery, New York University-Hospital for Joint Diseases, New York, New York 10003, USA.
Ong
Bernard C
BC
Jazrawi
Laith M
LM
Joseph
Thomas
T
Heywood
Christian S
CS
Rosen
Jeffrey
J
Rokito
Andrew S
AS
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*