Distal Clavicle Insufficiency: Reconstruction With Iliac Crest Autograft of the Distal Clavicle and Acromioclavicular-Coracoclavicular Reconstruction

Distal clavicle insufficiency, or a loss of the bony structure of the distal clavicle, generally after an injury or surgical procedure, may result in shoulder pain, dysfunction, scapular dyskinesia, and chronic acromioclavicular joint instability. If more than 15 to 20 mm of the distal clavicle is m...

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Main Authors: Mikalyn T. DeFoor, M.D., Michael G. Rizzo, M.D., Marco Adriani, M.D., Ryan J. Whalen, B.S., C.S.C.S., Samuel C. Hurley, Nate J. Dickinson, B.A., CAPT. Matthew T. Provencher, M.D., M.B.A., MC, USNR (Ret.)
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Arthroscopy Techniques
Online Access:http://www.sciencedirect.com/science/article/pii/S2212628725000659
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author Mikalyn T. DeFoor, M.D.
Michael G. Rizzo, M.D.
Marco Adriani, M.D.
Ryan J. Whalen, B.S., C.S.C.S.
Samuel C. Hurley
Nate J. Dickinson, B.A.
CAPT. Matthew T. Provencher, M.D., M.B.A., MC, USNR (Ret.)
author_facet Mikalyn T. DeFoor, M.D.
Michael G. Rizzo, M.D.
Marco Adriani, M.D.
Ryan J. Whalen, B.S., C.S.C.S.
Samuel C. Hurley
Nate J. Dickinson, B.A.
CAPT. Matthew T. Provencher, M.D., M.B.A., MC, USNR (Ret.)
author_sort Mikalyn T. DeFoor, M.D.
collection DOAJ
description Distal clavicle insufficiency, or a loss of the bony structure of the distal clavicle, generally after an injury or surgical procedure, may result in shoulder pain, dysfunction, scapular dyskinesia, and chronic acromioclavicular joint instability. If more than 15 to 20 mm of the distal clavicle is missing, chronic posterior instability of the distal clavicle may ensue and impinge on the deltotrapezial fascia and scapular spine. Although soft tissue reconstruction of the acromioclavicular-coracoclavicular (AC-CC) ligaments is a reliable procedure, if there is 15 to 20 mm or more of distal clavicle missing, it may be difficult to restore the mechanics of the scapular and glenohumeral joint. These can be seen after open or arthroscopic Mumford procedures (distal clavicle excision), AC-CC reconstructions with fracture, distal clavicle fractures, and other mechanisms. This technique article outlines an approach to distal clavicle insufficiency (>20 mm of missing distal clavicle bone) with iliac crest bone autograft reconstruction of the distal clavicle augmented with AC-CC soft tissue reconstruction.
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spelling doaj-art-2f0dab80dbcc4953b133d452ed2b87302025-08-20T03:32:01ZengElsevierArthroscopy Techniques2212-62872025-06-0114610349610.1016/j.eats.2025.103496Distal Clavicle Insufficiency: Reconstruction With Iliac Crest Autograft of the Distal Clavicle and Acromioclavicular-Coracoclavicular ReconstructionMikalyn T. DeFoor, M.D.0Michael G. Rizzo, M.D.1Marco Adriani, M.D.2Ryan J. Whalen, B.S., C.S.C.S.3Samuel C. Hurley4Nate J. Dickinson, B.A.5CAPT. Matthew T. Provencher, M.D., M.B.A., MC, USNR (Ret.)6San Antonio Military Medical Center, Fort Sam Houston, Texas, U.S.A.Steadman Philippon Research Institute, Vail, Colorado, U.S.A.; The Steadman Clinic, Vail, Colorado, U.S.A.Steadman Philippon Research Institute, Vail, Colorado, U.S.A.; Department of Medical and Surgical Specialties, University of Brescia, Brescia, ItalySteadman Philippon Research Institute, Vail, Colorado, U.S.A.Steadman Philippon Research Institute, Vail, Colorado, U.S.A.Steadman Philippon Research Institute, Vail, Colorado, U.S.A.Steadman Philippon Research Institute, Vail, Colorado, U.S.A.; The Steadman Clinic, Vail, Colorado, U.S.A.; Address correspondence to Matthew T. Provencher, M.D., M.B.A., MC, USNR (Ret.), Steadman Philippon Research Institute, The Steadman Clinic, 181 West Meadow Drive, Suite 400, Vail, CO 81657, U.S.A.Distal clavicle insufficiency, or a loss of the bony structure of the distal clavicle, generally after an injury or surgical procedure, may result in shoulder pain, dysfunction, scapular dyskinesia, and chronic acromioclavicular joint instability. If more than 15 to 20 mm of the distal clavicle is missing, chronic posterior instability of the distal clavicle may ensue and impinge on the deltotrapezial fascia and scapular spine. Although soft tissue reconstruction of the acromioclavicular-coracoclavicular (AC-CC) ligaments is a reliable procedure, if there is 15 to 20 mm or more of distal clavicle missing, it may be difficult to restore the mechanics of the scapular and glenohumeral joint. These can be seen after open or arthroscopic Mumford procedures (distal clavicle excision), AC-CC reconstructions with fracture, distal clavicle fractures, and other mechanisms. This technique article outlines an approach to distal clavicle insufficiency (>20 mm of missing distal clavicle bone) with iliac crest bone autograft reconstruction of the distal clavicle augmented with AC-CC soft tissue reconstruction.http://www.sciencedirect.com/science/article/pii/S2212628725000659
spellingShingle Mikalyn T. DeFoor, M.D.
Michael G. Rizzo, M.D.
Marco Adriani, M.D.
Ryan J. Whalen, B.S., C.S.C.S.
Samuel C. Hurley
Nate J. Dickinson, B.A.
CAPT. Matthew T. Provencher, M.D., M.B.A., MC, USNR (Ret.)
Distal Clavicle Insufficiency: Reconstruction With Iliac Crest Autograft of the Distal Clavicle and Acromioclavicular-Coracoclavicular Reconstruction
Arthroscopy Techniques
title Distal Clavicle Insufficiency: Reconstruction With Iliac Crest Autograft of the Distal Clavicle and Acromioclavicular-Coracoclavicular Reconstruction
title_full Distal Clavicle Insufficiency: Reconstruction With Iliac Crest Autograft of the Distal Clavicle and Acromioclavicular-Coracoclavicular Reconstruction
title_fullStr Distal Clavicle Insufficiency: Reconstruction With Iliac Crest Autograft of the Distal Clavicle and Acromioclavicular-Coracoclavicular Reconstruction
title_full_unstemmed Distal Clavicle Insufficiency: Reconstruction With Iliac Crest Autograft of the Distal Clavicle and Acromioclavicular-Coracoclavicular Reconstruction
title_short Distal Clavicle Insufficiency: Reconstruction With Iliac Crest Autograft of the Distal Clavicle and Acromioclavicular-Coracoclavicular Reconstruction
title_sort distal clavicle insufficiency reconstruction with iliac crest autograft of the distal clavicle and acromioclavicular coracoclavicular reconstruction
url http://www.sciencedirect.com/science/article/pii/S2212628725000659
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