case_images: PMC8783312_01
case_images: preoperative imaging, A) AP X-rays; B) lateral X-rays; C) CT-scan coronal view; D) and sagittal view
case_images: PAMJ-40-218-g001.jpg
case_images: PMC8783312_01_PAMJ-40-218-g001.jpg
case_images: F1
case_images: Diagnosis assessment: the initial morphological assessment found a type 3 ACD and a displaced fracture of the CP at the coracoclavicular ligaments insertion with no breach to the lower coracoid cortex (Figure 1).
case_images: prototype representation of the fracture line (in red) and of the 3 lacings performed, A) AP view of the first lacing; B) AP view with representation of a "gull winged" node; C) and lateral view
case_images: PAMJ-40-218-g002.jpg
case_images: PMC8783312_01_PAMJ-40-218-g002.jpg
case_images: F2
case_images: The first "gull-winged" lacing between the 2 coracoclavicular ligaments is perpendicular to the fracture line, and the 2 other lacings are trans ligamentous (Figure 2).
case_images: A) post-operative X-rays on day 1, AP; B) and lateral view
case_images: PAMJ-40-218-g003.jpg
case_images: PMC8783312_01_PAMJ-40-218-g003.jpg
case_images: F3
case_images: Follow-up and outcomes: postoperatively the patient was immobilized in a shoulder brace for 6 weeks, passive range of motion was authorized immediately after surgery and X-rays control (Figure 3).
case_images: A) post-operative X-rays on day 45, AP; B) and lateral view
case_images: PAMJ-40-218-g004.jpg
case_images: PMC8783312_01_PAMJ-40-218-g004.jpg
case_images: F4
case_images: Acromioclavicular arthrorisis pins were removed at 6 weeks without any complications (Figure 4).
case_images: bilateral active mobility 3 months postoperatively, A) flexion; B) external rotation; C) internal rotation
case_images: PAMJ-40-218-g005.jpg
case_images: PMC8783312_01_PAMJ-40-218-g005.jpg
case_images: F5
case_images: The clinical examination (Figure 5) at 3 months found a constant score of 92/100 (active mobility 40/40, pain 15/15, daily activities 12/20, strength 25/25).
case_images: CT-scan views 3 months post operatively, A) coronal view; B) sagittal view
case_images: PAMJ-40-218-g006.jpg
case_images: PMC8783312_01_PAMJ-40-218-g006.jpg
case_images: F6
case_images: The imaging checkup at 3 months (X-rays and computerized tomography) showed a partially consolidated fracture with a satisfactory reduction associated with a bone callus allowing the resumption of sports activities (Figure 6).
case_images: three-dimensional reconstruction showing the reduction and the callus of the coracoid process at 6 months
case_images: PAMJ-40-218-g007.jpg
case_images: PMC8783312_01_PAMJ-40-218-g007.jpg
case_images: F7
case_images: At 6 months, bone consolidation was fully attained (Figure 7), and the patient had completely gone back to her previous professional and sport activities (constant score of 100/100).