Open Weaver-Dunn (Modified)
The Weaver-Dunn procedure and modifications thereof is a tradional mode of fixation for Acromioclavicular Joint Dislocations (AC Joint). The true Weaver-Dunn, described in 1972 [1], comprises excision of the lateral end of clavicle and tranfer of the coraco-acromial ligament (CAL).
Modifications include the addition of a coraco-clavicular stabiliser, usually a screw or suture around the coracoid & clavicle.
The modified technique below, is that described by Copeland in 1995 [2].
1. A Longitudinal incision (strap) is made over the AC joint extending down over the coracoid. The lateral end of clavicle will be found to have ruptured the delto-trapezial fascia and possibly button-holed through trapezius.
2. The lateral end of clavicle is excised, obliquely.
3. The CAL is mobilised with a small amount of bone from the acromion.
4. Drill holes are made in the clavicle.
5. A thick PDS cord is passed around the coracoid using a rotator cuff passer.
6. The cord can be passed through a drill hole in the clavicle, to avoid excessive anterior translation of the clavicle.
7. The PDS cord is tied, whilst the clavicle is held down and the scapula pushed up - reducing the dislocation. The CAL is then transferred to the lateral end of clavicle with two interposing sutures.
8. When reducing the joint it is essential to ensure translation is anterior, as well as inferior.
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