AC Joint Reconstruction
Surgical Photos

Figure 1: Shoulder Strap Incision - this is used because of the ability to extend the exposure if needed. It lies in the natural lines of the skin, making it a more cosmetic incision than would a transverse incision in this same location.

Figure 2: Developing the next layer the muscle/fascia plane of the deltoid and trapezius muscles.

Figure 3: Exposing the clavical (collar bone).

Figure 4: Seeing the edge of the unstable bone.

Figure 5: The holes have been drilled in the distal collar bone for the placement of the tendon graft after replacing the tone ligaments in their natural position around the coracoid process (not seen here) of the scapula (shoulder blade).

Figure 6: A special clamp, the Stedinsky Clamp (often used in open heart surgery) is used to pass the sutures around the coracoid process. These sutures aid in passing the actual tendon graft that has been prepared separately on the OR table for graft placement later in the procedure.

Figure 7: The guide sutures are passed prior to passing the graft.

Figure 8: The suture loops that are attached to the leading ends of the graft are passed through the guide sutures.

Figure 9: These loops are then passed under the coricoid process.

Figure 10: The graft follows the loops under the tip of the coricoid process.