Method and apparatus for internal fixation of an acromioclavicular joint dislocation of the shoulder
An apparatus and method for surgically reducing and internally fixing a shoulder acromioclavicular joint dislocation are disclosed. The apparatus preferably comprises a button and a washer, the washer being flexibly secured to the coracoid process of the scapula by means of a bone screw, the button and washer being secured together by means of a first suture. A second suture is provided secured between the button and a needle, such that the needle and associated button, may be advanced through a hole drilled through the clavicle, wherein the button and the washer may then be tightened, reducing the coracoclavicular distance, by means of the first suture connected therebetween, to reduce and hold a desired acromioclavicular joint dislocation.
1. A method for internal fixation of joint dislocations, the method comprises the steps of:
providing an apparatus comprising: an oblong button; a suture anchor; and a flexible coupling that is double looped and extends between the oblong button and the suture anchor, one loop of the flexible coupling extends through apertures in the oblong button and another loop of the flexible coupling extends through apertures in the suture anchor, wherein the flexible coupling includes free ends located at a common side of one of the oblong button and the suture anchor;
drilling first and second holes through respective portions of the joint dislocation;
passing the oblong button with the flexible coupling through the first hole;
pivoting the oblong button so as to engage the oblong button against a superior surface of the respective portion of the first hole;
securing the suture anchor at the second hole to engage a superior aspect of the respective portion of the second hole; and
reducing and fixing the distance between the oblong button and the suture anchor by traction of the flexible coupling extending between the oblong button and the suture anchor.
2. The method according to claim 1 , in which the reducing step is carried out before the step of securing the suture anchor.
3. The method according to claim 1 , in which the apparatus is also provided with a needle that is flexibly attached to the oblong button which is subsequently uncoupled from the oblong button, after the oblong button has been advanced through the hole.
4. The method according to claim 1 comprises: fixing acromioclavicular joint dislocations, wherein the respective portions are the clavicle and the coracoid.
5. The method according to claim 4 , wherein the engaging step includes flipping the oblong button to position the oblong button against a superior surface of the clavicle.
6. The oblong button for use in the method according to claim 1 , wherein the apertures comprise first and second apertures which are oblong, a longitudinal mid-line of the respective oblong apertures being located substantially about a longitudinal mid-line of the oblong body.
7. The button according to claim 6 , in which the button has a width in the range of about 2.5 mm to about 4.0 mm.
8. The button according to claim 6 , in which the button has a width in the range of about 3.25 mm to about 4.0 mm.
9. The button according to claim 6 , in which the button has a length in the range of about 7.5 mm to about 12.5 mm.
10. The button according to claim 6 , in which the button has a length in the range of about 9 mm to about 11 mm.
11. The suture anchor for use in the method according to claim 1 , which comprises a washer body adapted for engagement with a bone anchor, the washer having at least two peripheral apertures.
12. The washer according to claim 11 in which the bone anchor is a bone screw and the body defines at least one screw-retaining aperture and at least two peripheral apertures is at least four peripheral apertures.
13. The washer according to claim 11 , in which the washer has a diameter in the range of 8 mm to 14 mm.