Luggage tag technique of anatomic fixation of displaced acromioclavicular joint separations.
Acromioclavicular joint dislocations are common injuries in active individuals. Most of these injuries may be treated nonoperatively. However, many techniques have been described when surgical management is warranted. A recent biomechanical study favors anatomic reconstruction of the conoid and trapezoid ligaments and the acromioclavicular joint capsule, as opposed to the traditional technique of excision of the lateral end of clavicle and transfer of the coracoacromial ligament to the intramedullary canal of the distal clavicle. We present a modification of the anatomic fixation technique using a luggage tag method, which places a graft under the base of the coracoid. This procedure has been associated with few redisplacements of the distal clavicle, reliable pain relief, and minimal postoperative morbidity. We found the luggage tag technique provides anatomic fixation of the distal clavicle and restoration of coronal and sagittal plane stability to the injured acromioclavicular joint. This procedure should reduce the possibility of coracoid fracture and decreases the risk of hardware complications associated with reconstruction techniques that violate the base of the coracoid process.


METHODS
Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Baldwin
Keith
K
Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, 2nd Floor, Silverstein Building, Philadelphia, PA 19104, USA.
Namdari
Surena
S
Andersen
Jaron R
JR
Lee
Brian
B
Itamura
John M
JM
Huffman
G Russell
GR
D000173:Acromioclavicular Joint / Q000293:injuries / Q000601:surgery*; D000328:Adult; D000368:Aged; D001696:Biomechanical Phenomena; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery*; D008023:Ligaments, Articular / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D053441:Suture Anchors; D053656:Tenodesis / Q000295:instrumentation / Q000379:methods*; D055815:Young Adult