Surgical Treatment of Acute Acromioclavicular Dislocation Using Modified Henry's Procedure

Abstract

Since 2005, the authors used modified Henry's procedure as a surgical treatment for acute complete acromioclavicular dislocation. Surgery was indicated for Rockwood type III, IV or V injury in young athletes or heavy labors. Under general anesthesia, the acromioclavicular joint was exposed and the ruptured disc was excised. Two holes were made on the undersurface of the lateral clavicle and one hole was made on the top of the coracoid process. A strip of fascia lata two centimeters in width and eight centimeters in length was collected. After over-reduction of the acromioclavicular joint and Kirschner wires fixation, the folded strip of fascia was grafted for the coracoclavicular ligament. The graft fixation on the clavicle was performed in a pull-out manner and on the coracoid a bone anchor was used. Five patients were reviewed more than six months after surgery. They were all men and the age at the surgery ranged from 15 to 40 (average, 21) years. Although one patient experienced slight pain, other patients had no pain. There was none who had limitation of the shoulder motion, weakness or limitation in the daily living. Radiologically, one case was evaluated as residual subluxation and the others were evaluated as good reduction. Although this report is preliminary, the modified Henry's procedure is supposed to be the most effective option for the treatment of the acromioclavicular dislocation.