Acromioclavicular joint dislocation with Tightrope fixation

Case contributed by Domenico Nicoletti
Diagnosis certain

Presentation

Fall from horse.

Patient Data

Age: 60 years
Gender: Male

XR right shoulder

x-ray

Widening of the acromioclavicular joint with elevation of the clavicle relative to the acromion and widening of the coracoclavicular distance consistent with an acromioclavicular joint injury (Rockwood type 3).

A small fragment at the inferior glenoid rim in keeping with a Bankart lesion.

XR right shoulder

x-ray

After TightRopeTM fixation significant reduction in acromioclavicular dislocation.

Case Discussion

The coracoclavicular ligament complex is composed of the conoid and trapezoid ligaments. These ligaments are different with respect to function and orientation, thereby mediating acromioclavicular joint stability. Ideal reconstruction methods should roughly replicate the trapezoid and the conoid ligaments in order to ensure that a normal coracoclavicular interval is maintained until the soft tissue around the coracoclavicular ligaments fully heals. Therefore a special TightRope fixation system (Twin Tail TightRopeTM) is used to anatomically reconstruct the coracoclavicular ligament to achieve ideal fixation and avoid complications.

Radiographer: TSRM Fabio Imola

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