Chinese Journal of Tissue Engineering Research ›› 2015, Vol. 19 ›› Issue (42): 6759-6763.doi: 10.3969/j.issn.2095-4344.2015.42.007

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Digital anatomical analysis of drilling position of the clavicle in coracoclavicular ligament reconstruction

Chen Yu, Song Xuan, Lu Hua, Zhang Tian-hao, Yao Bing   

  1. Department of Orthopedics, Chongming Branch, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 202150, China
  • Online:2015-10-08 Published:2015-10-08
  • About author:Chen Yu, Attending physician, Department of Orthopedics, Chongming Branch, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 202150, China
  • Supported by:

    the Key Specialty Construction of Shanghai Higher Vocational Education, No. FY(14)700-A5-1-17, FY(15)700-A6-1-10

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Abstract:

BACKGROUND: Coracoclavicular ligament reconstruction with transclavicular-transcoracoid drilling is an effective surgical technique to treat acromioclavicular dislocation. A good drilling in the clavicle leads to a perfect bony tunnel and a good surgery.
OBJECTIVE: To observe the effects of different drilling positions of the clavicle on the location of bony tunnels in coracoclavicular ligament reconstruction.
METHODS: Sixty three-dimensional digital models of the clavicle and coracoid process were constructed by Mimics13.0. Virtual transclavicular-transcoracoid bony tunnels were established according to different surgical planes with different drilling positions in the clavicle. Parameters of these bony tunnels were measured, and the safety was evaluated. Option 1: The drilling was made 30 mm distal to the clavicle, located in the center of the front and rear edges of the clavicle surface. Option 2: The drilling was made 40 mm distal to the clavicle, located in the center of the front and rear edges of the clavicle surface. Option 3: The drilling was made at the straight line of tapered nodule tip and the midpoint of the base of the coracoid process, located at the rear edge of the clavicle upper surface.
RESULTS AND CONCLUSION: Bony tunnels in option 1 were extremely on the inside of the coracoid. Bony tunnels in options 1 and 2 were not in the center of clavicle. Bony tunnels in option 3 were in the center of both 
clavicle and coracoid. The method of locating the drilling position with a certain distance to the distal clavicle leads to different results in man’s and woman’s models. To ensure that the bony tunnel can pass through the center of clavicle and coracoid, it is suggested to drill at the straight line of tapered nodule tip and the midpoint of the base of the coracoid process and nearby the rear edge of the clavicle upper surface. 

Key words: Clavicle, Ligaments, Anatomy, Shoulder Dislocation