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Arthroscopic stabilisation of an acute acromioclavicular dislocation grade III in a patient with ectopic insertion of the pectoralis minor: technical considerations

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Minuesa Asensio, Álvaro and Barrio Asensio, María del Carmen and González Gómez, Ignacio and Murillo González, Jorge Alfonso (2016) Arthroscopic stabilisation of an acute acromioclavicular dislocation grade III in a patient with ectopic insertion of the pectoralis minor: technical considerations. Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 24 (7). pp. 2197-2199. ISSN 0942-2056

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Official URL: http://dx.doi.org/10.1007/s00167-014-3463-x




Abstract

The different approaches used in arthroscopic stabilisation of the acromioclavicular joint are well known. However, and despite a great incidence of ectopic pectoralis minor insertion, an alternative choice for the use of arthroscopic portal has not being sufficiently described. Here, we describe a case of acute acromioclavicular dislocation grade III. The arthroscopic stabilisation was achieved using the TightRope (Arthrex, Naples, USA) implant. Through this technique, the approach to the articular portion of the coracoid process can be made intra-articularly or from the subacromial space. We accessed intra-articularly, by opening the rotator interval to reach the coracoid process from the joint cavity. After opening the rotator interval, an ectopic insertion of the pectoralis minor was observed. The choice of approach of the coracoid process from the subacromial space would have complicated the intervention, making it necessary to sever the ectopic tendon to complete the technique, lengthening the surgical time and increasing the chance of complications. For this reason, the use of a standard posterior portal providing intra-articular arthroscopic access through the rotator interval is recommended since the aforementioned anatomical variation is not infrequent.

Level of evidence Therapeutic studies—investigating the results of treatment, Level V.


Item Type:Article
Additional Information:

Received: 28 March 2014 / Accepted: 24 November 2014 / Published online: 2 December 2014

Uncontrolled Keywords:Acromioclavicular joint ; Arthroscopic stabilisation ; Pectoralis minor ; TightRope® technique
Subjects:Medical sciences > Medicine > Anatomy
Medical sciences > Medicine > Surgery
Medical sciences > Medicine > Physical medicine and medical rehabilitation
ID Code:38521
Deposited On:15 Jul 2016 07:16
Last Modified:22 Mar 2018 08:31

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