Pdf modified weaverdunn procedure for acromioclavicular joint. The absence of ac shock can also protect the surgery and fibrous tissue that grows in ac space. Fox valley orthopedics acromioclavicular joint reconstruction modified weaver dunn surgical description the acromioclavicular joint reconstruction, or weaverdunn procedure, is used to treat a patient with a painful and unstable acromioclavicular ac joint following a shoulder separation injury. The optimal operative method for acromioclavicular joint reconstruction remains controversial.
The procedure is performed for functional rather than cosmetic. Distal clavicle osteolysis after modified weaverdunn s procedure for chronic acromioclavicular dislocation. Management of chronic unstable acromioclavicular joint. The magnitude of applied force determines the degree of injury. The procedure is done to essentially replace the coracoclavicular ligaments with the coracoacromial ligament. Shoulder surgery shoulder replacement bankart repair weaver dunn procedure ulnar collateral ligament reconstruction laminetcomia surgery brunelli procedure. If adjuvant fixation has been used, the patient is allowed to use the arm for adls, below the shoulder. To compare the subjective outcome of acromioclavicular joint. Acromioclavicular joint dislocation types iv to vi. For ac separation, transfer of corocoacromial ligament to distal clavicle. Open weaverdunn modified the weaverdunn procedure and modifications thereof have the best results for stabilisation of the ac joint. The majority of acromioclavicular joint injuries result from direct trauma to the shoulder.
Modified weaverdunn procedure for acromioclavicular joint. Surgical reconstruction for chronic painful acromioclavicular. Pdf distal clavicle osteolysis after modified weaver. This article presents a modified weaver dunn procedure consisting of lateral clavicle resection and reduction, coracoclavicular fixation with suture or surgical tape, and coracoacromial ligament transfer for the treatment of these injuries. Murphy, md board certified orthopedic surgeon specializing in sports medicine and arthroscopy 10475 centurion pkwy. During the surgery, the physician uses a coracoacromial ligament to reconstruct two other torn ligaments that often tear during severe ac joint separations. Modified weaver dunn procedure for acromioclavicular joint dislocations andrew s. Weaver dunn procedure orthopaedic surgery elearning. Athletes who participate in contact sports, such as hockey, football, rugby. Acj stabilisation arthroscopicmodified weaverdunnlars. Pdf modified weaverdunn procedure for acromioclavicular. In recent years, a technique using autogenous semitendinosus tendon. Acj reconstruction using the modified weaverdunn procedure group a.
Weaver dunn ac joint reconstruction postop protocol. It is a major spine operation with residual scar tissue and may result in postlaminectomy syndrome. Weaver dunn procedure have been popular and fairly successful methods to treat severe acromioclavicular separations, despite the fact that reconstructions have been done a number of ways. In fact, the modified weaver dunn s technique is a common procedure for the treatment of ac joint dislocation 1, 3, 1422. Modified weaver dunn procedure gives a satisfactory longterm functional outcome in type 3 acj dislocation. Our orthopedist documented a weaver dunn procedure.
The original article however showed a failure rate of 28% in a small series of 15 patients. Arthroscopic views of the right shoulder in the beachchair position. We report on the results of a technique for salvaging failed modi. Determine how you would code this situation before looking at the box below for the answer. Surgery open procedure anterior deltoid split and small detachment from acromion. If so, this should be done by direct communication with. This artificial ligament provides a strong, flexible and permanent solution to ac joint dislocations. Hey all,brbri suffered a grade 3 ac dislocation early this year while snowboarding in switzerland and the time has now come for me to have the weaver dunn procedure. This protocol is intended to be a general outline only. Pdf a modified weaverdunn procedure without need for internal. To compare the subjective outcome of acromioclavicular joint acj reconstruction using the modified weaver dunn procedure versus the surgilig synthetic ligament. A modified weaver dunn procedure without need for internal fixation. Orthopedists perform weaver dunn procedures to repair acromioclavicular ac joint separation.
Modified weaverdunn procedure using of mersilene tape was done. The mean time between injury and the index procedure was 18 month range from 9 28. Modified weaver dunn procedure the modified weaverdunn procedure is designed to improve pain and function in cases of acromioclavicular joint dislocation. Protection in immobilizer or sling patient out of immobilization for elbow, wrist and hand exercises putty exercises may begin gentle codmans exercises may begin biceptriceps isometrics. Acromioclavicular joint stabilisation lockdown weaver dunn procedure page 1 of 4. Modified weaver dunn is a simple well iv dislocation. Contact our orthopedic surgeon dr kevin murphy at 9046340640 for more details.
Allarthroscopic doublebundle coracoclavicular ligament. Weaver dunn reconstruction with clavicular hook plate augmentation wd. The modified weaver dunn method is one of the most popular methods. In their original series, weaver and dunn reported a. Weaver dunn procedure for treatment of acj dislocation. This paper reports a very rare case of distal clavicle osteolysis after modified weaver dunn procedure for the treatment of chronic acromioclavicular joint dislocation.
Weaver dunn procedure for stabilisation of the acromioclavicular joint indications pain andor functional disruption failure to improve with nonoperative treatment. Distal clavicle osteolysis after modified weaver dunn s procedure for chronic acromioclavicular dislocation. Fox valley orthopedics acromioclavicular joint reconstruction modified weaver dunn surgical description the acromioclavicular joint reconstruction, or weaver dunn procedure, is used to treat a patient with a painful and unstable acromioclavicular ac joint following a shoulder separation injury. Weaver dunn procedure demands the excision of the distal clavicle and transfer of the ca ligament onto the cc ligament. We describe a modification to the weaverdunn procedure, which aims to establish a stable reduction with bonetobone healing, provided by bone plug fixation.
Distal clavicle osteolysis after modified weaverdunns procedure for chronic acromioclavicular dislocation. This article presents a modified weaver dunn procedure consisting of lateral clavicle resection and reduction, coracoclavicular fixation with suture or surgical tape, and coracoacromial ligament transfer for the treatment of. Acromioclavicular joint stabilisation lockdownweaver dunn. Classically, the weaver dunn 9 wd, modified dewar 10, cadenat 11, and bosworth 12 procedures have been used all with varying results. Anatomic coracoclavicular reconstruction surgical technique. Carl zetterberg department of orthopedics uddevalla hospital, sweden. Twoyear outcomes after primary anatomic coracoclavicular. Bs and 6 after modified weaver dunn reconstruction with mersilene tapepalmarislongus tendon graft reconstruction wd. Biomechanically this construct seemed weaker and led to greater displacement 10. The cc ligaments have been shown to fail by avulsion or midsubstance tear at 589 n. Modified weaverdunn procedure the use of semitendinosus. W acromioclavicular joint, coracoacromial ligament, modified weaver dunn procedure, synthetic suture, tendon reconstruction procedure introduction % % athletes 1 are in patients 1 optimal sur controversial. Originally described by james weaver and harold dunn in 1972, 33 the weaver dunn procedure wd involves transfer of the coracoacromial ca ligament from the acromion to the lateral end of the clavicle.
The modified weaver dunn procedure involves transfer of the coracoacromial ligament into the distal end of the clavicle after approximately a 10 to 12mm resection has been accomplished. The physician reserves the right to either advance or delay this protocol as deemed necessary. There is no gold standard in acj reconstruction acjr and many methods have been described in literature, with variable outcomes. Weaverdunn procedure for stabilisation of the acromioclavicular joint indications pain andor functional disruption failure to improve with nonoperative treatment. A weaver and dunn reconstruction is performed for a separation of the acromioclavicular joint. This reconstruction is supported by an absorbable cord. Open weaverdunn modified the weaver dunn procedure and modifications thereof have the best results for stabilisation of the ac joint. The coracoacromial ligament transfer and the lateral portion of the clavicle removal are done to reconstruct the torn coracoclavicular ligaments. Pdf functional outcome of modified weaver dunn technique. There were 15 patients with rockwood type iii injury. Distal clavicle osteolysis is a rare disorder that may be caused by acute trauma, chronic overuse, systemic disorders hyperparathyroidism, connective tissue disorders, and infection, or surgery 912, 2325. Anatomic reconstruction of coracoclavicular ligaments with autogenous. Case report distal clavicle osteolysis after modified weaver. In this procedure, the coracoacromial ligament is transferred to the distal clavicle.
Weaver dunn procedure was considered the gold standard in acj reconstruction, especially for chronic cases. Pdf distal clavicle osteolysis after modified weaverdunns. Jun 26, 2001 we operated on 17 patients suffering from chronic acromioclavicular instability after such dislocation using a modified weaver dunn procedure, in which there is no lateral clavicular end resection, the coracoacromial ligament graft is sutured to the inferior part of the clavicle by transosseal sutures, and a bosworth coracoclavicular screw is. Modified weaverdunn procedure for type 3 acromioclavicular. The procedure is performed for functional rather than cosmetic purposes dr. For revision, several techniques including modifications of the weaver dunn procedure have been suggested. Weaver dunn protocol for ac separation, transfer of.
Acromioclavicular joint reconstruction using a tendon. Distal clavicle osteolysis after acromioclavicular joint stabilization has only been described after the use of hardware for clavicle stabilization or synthetic graft causing a foreign body reaction. Modified weaver dunn procedure versus the use of semitendinosus autogenous tendon graft for acromioclavicular joint reconstruction galal hegazy, hesham safwat, mahmoud seddik, ehab a. Jun 27, 2016 the weaver dunn operation is a wellestablished procedure for the treatment of chronic acjoint instability. Surgical technique this article presents an allarthroscopic weaverdunn technique for acute or chronic acromioclavicular ac joint dislocation. Weaver dunn protocol for ac separation, transfer of corocoacromial ligament to distal clavicle.
Weaver dunn procedure, first described in 1972, avoids the use of metallic implants and continues to be a popular procedure. The weaver dunn procedure aims to stabilize the acromioclavicular ac joint following a shoulder separation surgery. Use sling but not swathe as it may pull the arm inferiorly. Distal clavicle osteolysis after modified weaverdunns. Fox valley orthopedics acromioclavicular joint reconstruction. The coracoacromial ligament is then transferred and secured to the distal clavicle.
The modified weaverdunn procedure is designed to improve pain and function in cases of acromioclavicular joint dislocation. Surgical treatment of chronic acromioclavicular joint. We present the case of a we present the case of a thirtyeight year old male, who suffered blunt trauma in the anterolateral region of the right shoulder that caused an acromioclavicular. Subsequently, this method has been more commonly augmented with sutures, wire cerclage, or tendon grafts for reinforcement. Modifiedweaver dunn procedure reading shoulder unit. Weaver dunn ac joint reconstruction postop protocol this protocol is intended to be a general outline only. Modified weaver dunn procedure the modified weaver dunn procedure is designed to improve pain and function in cases of acromioclavicular joint dislocation. Each of these procedures provides different approach to fixation andor reconstruction of the ac joint and the cc ligaments.
This is augmented with a suture, tape, or screw that keeps the acromioclavicular joint reduced while the ligament transfer heals. In their study, they found that the mean anterior, posterior and superior translation of an intact specimen after a 70n load was applied was 9. Surgilig ac ligament surgilig was developed by the nottingham shoulder unit and was first introduced in november 2001 as a method of addressing failed acj surgery but has gained popularity in the last three years as a primary method of stabilizing the disrupted acj. Modified weaver dunn procedure versus the use of semitendinosus autogenous tendon graft for acromioclavicular joint reconstruction.
Modifications include the addition of a coracoclavicular stabiliser, usually a screw or suture around the. This article presents a modified weaverdunn procedure consisting of lateral clavi cle resection and reduction, coracoclavicular fixation with suture or surgical. The procedure is performed under general anaesthetic in association with regional anaesthesia. Eduard alentorngeli,1 fernando santana,1 felipe mingo,1 ignasi pinol,1 albert solano,2 lluis puigverdie,1 and carles torrens1. Protection in immobilizer or sling patient out of immobilization for elbow, wrist and hand exercises putty exercises may. Arthroscopic coracoacromial ligament transfer augmented. Since the first description of the weaver dunn procedure, several studies have described the clinical and radiological results that can be expected postoperatively. Allarthroscopic weaverdunnchuinard procedure with double. The modified weaverdunn method is one of the most popular methods. In ten patients, a modified weaver dunn procedure was performed, in the other ten patients.
Jan 01, 2004 the original weaver dunn procedure involves a lateral clavicle resection, reduction of the dislocated clavicle, and coracoacromial ligament transfer to the lateral clavicle, without additional. In this procedure, 78 mm of bone is removed from the distal clavicle and 23 mm is removed from the acromion. Weaver dunn protocol by dr kevin murphy jaxsportsdoc. The true weaverdunn, described in 1972 1, comprises excision of the lateral end of clavicle and tranfer of the coracoacromial ligament cal. The true weaver dunn, described in 1972 1, comprises excision of the lateral end of clavicle and tranfer of the coracoacromial ligament cal. Managing and recognizing complications after treatment of. May 31, 2016 modified weaver dunn procedure versus the use of semitendinosus autogenous tendon graft for acromioclavicular joint reconstruction galal hegazy, hesham safwat, mahmoud seddik, ehab a. Acromioclavicular joint stabilisation lockdownweaver dunn procedure page 1 of 4. The weaver dunn procedure 18 carries a risk of ongoing pain, in association with instability and recurrent subluxation, and results in only 30% of the strength and 10% of the stiffness of intact ligaments.
This article presents an allarthroscopic weaver dunn technique for acute or chronic acromioclavicular ac joint dislocation. Cp or 5 after modified weaver dunn reconstruc tion with coracoclavicular sc rew augmentation wd. Open anatomic coracoclavicular ligament reconstruction by. Acj stabilisation arthroscopicmodified weaver dunn lars ligamentsurgilig procedures introduction the guidelines that follow are a frame work of basic exercises and management strategies based on the patient who has had a stabilisation of the acromioclavicular joint acj. Classically, the weaver dunn wd, modified dewar, cadenat, and bosworth procedures have been used all with varying results. Journal of orthopaedic surgery and research biomed central. This article presents a modified weaverdunn procedure consisting of lateral clavicle resection and reduction, coracoclavicular fixation with suture or surgical.
Zuckerman, md the acromioclavicular joint is commonly affected by trauma to the shoulder girdle due to its subcutaneous position. Drill holes are made in the coracoid, and the distal clavicle and mersilene tape is passed through the drill holes. We prefer to place the patient in the beachchair position. Weaver and dunn published their description of distal clavicle resection and cc ligament reconstruction in 1972. After reconstruction using the described techniques, they determined that the weaver dunn method. This is a generally successful type of surgery involved in the treatment of severe separated shoulders developed by james k. Pdf a modified weaverdunn procedure without need for.
Modified weaverdunn procedure versus the use of a synthetic. The failure rate after surgical acromioclavicular ac joint stabilization is of up to 10%. Elbow must be supported at all times for 6 weeks postop. Modifications include the addition of a coracoclavicular stabiliser, usually a screw or. Weaver dunn ac joint reconstruction postop protocol 20191021t15. Modified weaverdunn procedure revised may 2005 postop days 1 7 sling x 4 weeks even while sleeping place pillow under shoulder arm while sleeping for comfort hand squeezing exercises elbow and wrist arom with shoulder in neutral position at side supported pendulum exercises ice pack goals pain control protection weeks 1 4.
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