Stoll Kurt E, Hendy Benjamin, Brown Treg, Cohen Nathaniel, Lee Thay Q, Namdari Surena, Davidson Phil
Rothman Institute of Orthopaedics at Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania, U.S.A.
The Orthopaedic Institute, Carbondale, Illinois, U.S.A.
Arthrosc Tech. 2022 Apr 22;11(5):e819-e826. doi: 10.1016/j.eats.2021.12.042. eCollection 2022 May.
Acromioclavicular (AC) joint injuries occur with a traumatic load to the lateral aspect of the shoulder and account for 9% of all shoulder girdle injuries. Rockwood classified AC joint injuries as type I though type VI, based on severity of injury, radiographic findings, and reducibility of the AC joint. Type I and II injuries are typically managed nonoperatively, whereas type IV, V, and VI are managed operatively to address the significant soft tissue disruption, persistent AC joint instability, and apical shoulder deformation. Treatment of type III injuries remain controversial. Several techniques have been described to treat AC joint injuries with no consensus for optimal treatment. "Anatomic" double-tunnel coracoclavicular ligament reconstruction is one currently popular technique to address AC joint injuries; however, clavicle and coracoid fractures are well-described complications of this technique. The objective of this technical report is to describe our preferred technique to address AC joint injuries. This technique involves using a looped braided polyester prosthetic band and low-profile buckle with allograft augmentation using a device to pass materials around the coracoid process.
肩锁关节（AC）损伤是由于肩部外侧受到创伤性负荷所致，占所有肩胛带损伤的9%。Rockwood根据损伤的严重程度、影像学表现以及肩锁关节的可复性，将肩锁关节损伤分为I型至VI型。I型和II型损伤通常采用非手术治疗，而IV型、V型和VI型损伤则采用手术治疗，以处理严重的软组织损伤、持续的肩锁关节不稳定和肩部顶端变形。III型损伤的治疗仍存在争议。已经描述了几种治疗肩锁关节损伤的技术，但对于最佳治疗方法尚无共识。“解剖学”双隧道喙锁韧带重建术是目前治疗肩锁关节损伤的一种常用技术；然而，锁骨和喙突骨折是该技术常见的并发症。本技术报告的目的是描述我们治疗肩锁关节损伤的首选技术。该技术包括使用环形编织聚酯假体带和低调扣，并使用一种装置将材料绕过喙突进行同种异体移植增强。
