Proximally Based Conjoined Tendon Transfer for Coracoclavicular Reconstruction in the Treatment of Acromioclavicular Dislocation

Background: We report an alternative to the modified Weaver-Dunn technique that can achieve stable coracoclavicu-lar reconstruction while avoiding sacrifice of the coracoacromial arch. The purpose of this study was to retrospectively analyze the functional outcomes and radiographic features of patients treated with coracoclavicular ligament recon-struction with use of a proximally based conjoined tendon transfer. Methods: The cases of thirty-eight patients with type-IV, type-V, and selected type-III acromioclavicular dislocations according to the Rockwood classification system, who were followed for an average follow-up of 38.7 months, were evaluated retrospectively. Transfer of the lateral half of the conjoined tendon to the distal aspect of the clavicle in a proximally based fashion, with additional coracoclavicular fixation, was performed in all patients. At the latest follow-up evaluation, radiographic analysis and the scores on the American Shoulder and Elbow Surgeons, Constant and Murley, and Simple Shoulder Test questionnaires were used to provide a final evaluation of shoulder function. The ability to return to work and the ability to return to sports were also recorded. Results: At the time of final follow-up, the mean American Shoulder and Elbow Surgeons score was 91.4, with a mean pain score on the visual analog scale of 1.8, mean forward flexion of 148.2°, and mean external rotation of 38.0°. The mean Constant and Murley score was 90.6. The new number of positive answers on the Simple Shoulder Test was 10.9. The overall rate of satisfaction (an excellent or good result) was 89 % (thirty-four patients). Thirty-fiv