Primary Fixation of Acromioclavicular Joint Disruption

Acromioclavicular (AC) joint separations are frequently seen injuries and may lead to severe impairment of shoulder function. Numerous treatment options have been proposed in the literature. Although low-grade injuries (types I and II) should be initially managed nonsurgically, surgical management is typically recommended for high-grade lesions (types IV through VI). Surgery is suggested for type III lesions in heavy laborers or high-level athletes. Owing to the relatively high complication rates of modern anatomical double-tunnel AC reconstruction techniques, the authors present a preferred single-tunnel technique with additional AC joint suture cord cerclage for improved horizontal stability. This technique allows the combination of small drill hole diameter with ultra-high-strength suture tape material and large cortical fixation buttons.