title: Mini incision acromio-clavicular joint reconstruction using palmaris longus tendon graft.
abstract: BACKGROUND
  Conservatively managed acromio-clavicular dislocations leave the patients with significant disability. Various techniques have been described to manage such injuries operatively. However, all such techniques involve exposure of the coracoid and use of metallic implants. We present a series of eight patients managed with small incision and minimal soft tissue dissection using palmaris longus tendon graft. We treated eight patients (all males), with acute acromio-clavicular dislocation with a palmaris Longus tendon graft.
  
  
  METHODS
  The mean age of the patients at the time of final follow-up was 28.5 years (range 26-29 years), and the mean follow-up was 18 months (range 14-28 months). Functional assessment was done as per the DASH scores, along with a self-evaluation of the results. The vertical acromio-clavicular distance at final follow-up was compared to that at the time of presentation.
  
  
  RESULTS
  The mean DASH score at final follow-up was 3.01; on self-evaluation, all patients rated their result as good. The patients had no or minimal pain at final follow-up. The mean vertical acromio-clavicular distance reduced from a mean pre-operative baseline values of 10.26 ± 2-1.40 ± 0.855 mm at latest follow-up.
  
  
  CONCLUSIONS
  This is a mechanically sound technique, which required a small incision and minimal soft tissue dissection. It also does not require exposure of the coracoid, thus almost ruling out chances of significant neuro-vascular injury. The patients did not require any second surgery for implant removal. However, a longer follow-up with a larger number of patients is required to evaluate its long-term results and stability of the repair.
  
  
  CONCLUSIONS
  Acromio-clavicular reconstruction using the palmaris Longus tendon graft is a simple surgery worth trying by a surgeon not proficient in arthroscopic techniques.
authors.affiliation: Department of Orthopaedics, Pt. B.D. Sharma PGIMS, Rohtak, 124001, Haryana, India.
authors.forename: Paritosh
authors.initials: P
authors.lastname: Gogna
authors.forename: Reetadyuti
authors.initials: R
authors.lastname: Mukhopadhyay
authors.forename: Amanpreet
authors.initials: A
authors.lastname: Singh
authors.forename: Rohit
authors.initials: R
authors.lastname: Singla
authors.forename: Amit
authors.initials: A
authors.lastname: Batra
authors.forename: Narender Kumar
authors.initials: NK
authors.lastname: Magu
authors.forename: Rohit
authors.initials: R
authors.lastname: Nara
mesh_terms: D000173:Acromioclavicular Joint / Q000293:injuries*; D000328:Adult; D002968:Clavicle / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery*; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods; D016059:Range of Motion, Articular; D020127:Recovery of Function; D013710:Tendons / Q000637:transplantation*; D016896:Treatment Outcome; D014955:Wrist Joint
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