Presentation
Motor vehicle accident and injured the right shoulder. Right acromioclavicular instability was clinically diagnosed and surgically treated. Preoperative x-rays were not available for evaluation. The patient presented for post-operative x rays.
Patient Data
The immediate post-operative right shoulder/ right acromioclavicular view demonstrate TightRope fixation of the acromioclavicular joint . There is satisfactory right acromioclavicular reduction.
The patient continued to experienced pain and re-presented for imaging.
The patient experienced ongoing pain and re-presents for weight bearing views.
The views confirm ongoing right acromioclavicular instability and grade II injury.
The left acromioclavicular and coracoclavicular articulations are normal on neutral and weight bearing views.
The patient underwent open reduction and internal fixation (ORIF) with a clavicular hook plate and multiple fully threaded bicortical screws to surgically reduce the grade II injury.
Clavicular hook plate and multiple fully threaded bicortical screws to surgically reduce the grade II injury there are no post-operative complications.
Case Discussion
The TightRope fixation is a minimally invasive method of fixating and reducing acromioclavicular and tibiofibular syndesmotic injuries which allow a rapid return to normal activity post-trauma. It can also be used to re-attach the distal biceps brachii tendon in elbow injuries.
This is an example of a right acromioclavicular TightRope fixation.
There is a round clavicular endo button and an oblong coracoid endo button with a radiolucent fiber cable utilized to reduce the acromioclavicular joint. There is a well defined longitudinal lucency/tunnel through which the cable is threaded and tied.
The weight-bearing views on re-presentation demonstrate persistent or recurrent grade II acromioclavicular joint injury.
In this instance, the patient likely suffered a repeat injury post-fixation and underwent open reduction and internal fixation with a clavicular hook plate and bi-cortical screws.
Disclosure: I, Ashesh I Ranchod, have no actual or potential ethical or financial conflict of interest in relation to this device. This case is not intended to be a personal endorsement or recommendation of this product.
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