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Introduction
The distal clavicle fracture is a common shoulder injury. There are several treatment methods which can achieve good outcomes, of which coracoclavicular (CC) stabilization is one of the most popular surgical options. In CC stabilization, the step of passing a suture under the coracoid base is the most difficult step because the standar...
Context in source publication
Context 1
... of rotator cuff repair, it is discarded. However, in our study, we saved used Y-knot all-suture anchors and sterilized them for re-use. A sterile Y-knot allsuture anchor (Fig. 2) was modified by creating a 90-degree J-shape. The bifurcated tip of the Y-knot all-suture anchor was forced together into a single unit by a needle holder as shown in Fig. 3. The distal part of the slot suture device was bent into a J-shape using a needle holder (Fig. 4A, B). Then, the section next to the J-shape of the slot suture device was bent 90 degrees using two needle holders (Fig. 5). The resulting 90-degree J-shape was designed to pass easily under the actual coracoid process (Fig. 6A, ...
Citations
... Attempts to modify common surgical instruments have been made in the past to facilitate the passage of the suture under the coracoid base. For example, a Kirschner wire (K-wire) [9] or a Y-knot all-suture anchor [10] have been bent into U-shapes and used to pass the suture under the coracoid process. However, there were still problems with these instruments. ...
Unlabelled:
A distal clavicle fracture is a common shoulder injury. Coracoclavicular (CC) stabilization is a popular procedure for treating this injury. However, with this method, there is a technical difficulty in looping the suture under the coracoid base with instruments normally available in the operating room (OR). Herein, the authors describe modifying a pelvic suture needle to ease this process.
Case presentation:
An 18-year-old Thai female presented with left shoulder pain after a fall while cycling. The physical examination showed tenderness at the prominent distal clavicle. The radiograph of both clavicles showed a displaced distal clavicle fracture of the left shoulder. After discussing the treatment, she decided to have CC stabilization as the authors recommended.
Clinical discussion:
CC stabilization is one of the main surgical techniques used in treating an acute displaced distal clavicle fracture. The most important but difficult step of the CC stabilization is passing a suture under the coracoid base. To make this step easier, various commercial tools have been created, however, they are expensive ($1400-1500 per piece), and most operating rooms in resource-limited countries do not have them available. The authors modified a pelvic suture needle specifically for use in looping a suture under the coracoid process, which is hard to do with standard surgical tools.
... Currently, there are some specialized commercial instruments for use in CC stabilization which are matched to the shape of the coracoid process to make it easy to pass the suture under the coracoid base, but all of them are highly expensive (~$1400-1500 per piece) and thus often not available in ERs in resource-limited settings. There have been several attempts to devise a simple instrument for passing a suture under the coracoid base, for example modifying a Kirschner wire to pass a suture under the coracoid base [8] , or modifying a Y-knot all-suture anchor into a J-shape to pass a suture under the coracoid base [9] . However, these methods have limitations, i.e. a Kirschner wire is difficult to bend into the desired shape, and with the reused modified Y-knot all-suture anchor, there is a chance of infection. ...
Unlabelled:
A distal clavicle fracture is a common injury of the shoulder joint. Coracoclavicular (CC) stabilization is one of the recommended procedures for treating the distal clavicle fracture. However, it is difficult to pass the suture under the coracoid process with instruments normally available in the operating room (OR). Herein, the authors describe a simple technique to accomplish this suture passing quickly and easily using tools available in the OR.
Case presentation:
A 59-year-old Thai female presented with right shoulder pain after a fall. The physical examination showed a prominent bulge and tenderness at the right distal clavicle. A radiograph of both clavicles showed a right displaced distal clavicle fracture. After discussing the possible treatments with her, she decided to have CC stabilization as we recommended.
Clinical discussion:
In CC stabilization, the most important but difficult step is passing a suture under the coracoid base. There are some specialized commercial instruments which are matched to the shape of the coracoid process to make it easy to perform this step, but all are highly expensive (~$1400-1500 per piece) and thus often not available in ORs in resource-limited settings.
Conclusion:
The authors devised a technique using standard surgical instruments and materials available in all ORs to enable them to pass a suture easily and quickly under the coracoid base.
Introduction:
A common shoulder injury is a distal clavicle fracture which can be treated with various methods such as coracoclavicular (CC) stabilization, fixation with a distal clavicular locking plate, hook plate or tension band wiring. In CC stabilization, the most difficult step is passing a suture under the coracoid base because there is no standard instrument matched to the shape of the coracoid process. We propose a technique using a modified recycled corkscrew suture anchor to pass a suture under the coracoid base.
Case presentation:
A 30-year-old Thai female with a left clavicle fracture was scheduled for CC stabilization. In the step of passing a suture under the coracoid base, we used a modified recycled corkscrew suture anchor to quickly and easily perform this step.
Clinical discussion:
There are some specialized commercial tools which are designed to pass a suture under the coracoid base but all are very expensive (∼ $1400-1500 per piece). To overcome this problem, we modified a used sterilized corkscrew suture anchor to pass a suture under the coracoid base, normally done from the medial to lateral sides, recycling a device usually discarded after use.
