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First published on December 9, 2004, doi:10.1177/0363546504268038
This version was published on January 1, 2005
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The American Journal of Sports Medicine 33:61-67 (2005)
© 2005 American Orthopaedic Society for Sports Medicine

Stabilization of the Clavicle After Distal Resection

A Biomechanical Study

Darren P. Corteen, MD and Robert A. Teitge, MD*

From the Department of Orthopedic Surgery, Wayne State University, Detroit, Michigan

* Address correspondence to Robert A. Teitge, MD, Michigan Orthopaedic Specialty Hospital, 30671 Stephenson Highway, Madison Heights, MI 48071.

Background: The potential destabilizing effect of distal clavicle resection has received limited attention.

Hypothesis: Suturing the coracoacromial ligament to the undersurface of the distal clavicle after resection could counter clavicle instability.

Study Design: Controlled laboratory study.

Methods: The effect of ligament augmentation on posterior translation of the clavicle after resection was evaluated using 12 fresh-frozen cadaveric shoulders. Posterior clavicular displacement was measured after the application of a 70-N load under 4 different conditions: (1) the intact joint, (2) after distal clavicle resection, (3) clavicle resection plus acromioclavicular capsular ligament repair, and (4) clavicle resection plus acromioclavicular capsular ligament repair plus coracoacromial ligament augmentation.

Results: Mean displacements for each of the test conditions were as follows: (1) 5.60 mm, (2) 7.38 mm, (3) 7.54 mm, and (4) 6.34 mm. A 32% increase in posterior translation was measured after resection compared to the intact specimen. No reduction in posterior displacement was noted after capsular repair; however, displacement decreased significantly when capsular repair was coupled with ligament augmentation.

Conclusions: Results suggest that the destabilizing effect of clavicle resection can be partially countered by the proposed ligament augmentation.

Clinical Relevance: That the destabilizing effect of clavicle resection can be partially countered by the proposed ligament augmentation may be particularly relevant in cases of resection for posttraumatic arthritis after acromioclavicular separation in which some degree of preexisting acromioclavicular capsular attenuation and consequently acromioclavicular joint laxity may be presumed.

Key Words: acromioclavicular (AC) joint • distal clavicle • mumford • coracoclavicular ligament • distal clavicle resection






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