{"product_id":"acromioclavicular-case-3-tightrope-fixation","title":"ACROMIOCLAVICULAR [CASE 3] TightRope Fixation","description":"\u003cp\u003eAnatomical reduction of the acromioclavicular dislocation requires precision in creating two independent, aligned holes — one in the coracoid process and another in the clavicle — in a region of high vascularization and limited bone exposure, where any deviation of a few centimeters in the approach compromises retraction and visualization of the structures. This training presents reduction and fixation with the TightRope device through a minimally invasive longitudinal approach, guided by biplanar fluoroscopy, with a deliberate hypercorrection technique to compensate for the natural settling of soft tissues — all documented in 4K video, from the surgeon's direct perspective.\u003c\/p\u003e\n\u003ch4\u003eTRAINING FOCUS\u003c\/h4\u003e\n\u003cul\u003e\n\u003cli\u003ePatient positioning and radiographic views (anteroposterior and simulated axillary)\u003c\/li\u003e\n\u003cli\u003eSkin marking guided by dual fluoroscopic imaging\u003c\/li\u003e\n\u003cli\u003eInfiltration with vasoconstrictor anesthetic for bleeding control\u003c\/li\u003e\n\u003cli\u003eMinimally invasive longitudinal approach\u003c\/li\u003e\n\u003cli\u003eDetachment of the pectoral muscle and exposure of the superior surface of the clavicle\u003c\/li\u003e\n\u003cli\u003eDelimitation of the coracoid process with Langenbeck and Farabeuf retractors\u003c\/li\u003e\n\u003cli\u003eCreation of the hole in the coracoid process under direct visualization\u003c\/li\u003e\n\u003cli\u003eDrilling of the clavicle with a drill bit compatible with the TightRope\u003c\/li\u003e\n\u003cli\u003ePassage of the wires with Mixter forceps and guide instrumentation\u003c\/li\u003e\n\u003cli\u003eIntroduction and locking of the TightRope button\u003c\/li\u003e\n\u003cli\u003eReduction with deliberate hypercorrection and bone anchoring\u003c\/li\u003e\n\u003cli\u003eLayered suturing and closure of the surgical wound\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003ch4\u003eDETAILED CONTENT\u003c\/h4\u003e\n\u003cul\u003e\n\u003cli\u003e\n\u003cstrong\u003eBiplanar radiographic views:\u003c\/strong\u003e combination of anteroposterior and simulated axillary views for precise localization of the coracoid process and the lateral third of the clavicle prior to incision.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eMarking with a dermographic pen:\u003c\/strong\u003e transposition of fluoroscopic reference points onto the skin, reducing the risk of a poorly positioned approach and retraction difficulties.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eInfiltration with vasoconstrictor:\u003c\/strong\u003e bleeding control in a highly vascularized region, keeping the field clean throughout the dissection.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eTriple retraction of the coracoid process:\u003c\/strong\u003e combined use of Langenbeck and Farabeuf retractors for top-to-bottom bone exposure without residual soft tissue.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eIndependent, aligned holes:\u003c\/strong\u003e drilling of the coracoid process and the clavicle at calculated points to ensure a trajectory compatible with the TightRope device.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eWire passage guided by Mixter forceps:\u003c\/strong\u003e technique for transposing the needled wire through the created hole, preparing for implant introduction.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eLocking and testing of the TightRope button:\u003c\/strong\u003e traction maneuver to confirm adequate bone anchoring, verified by control fluoroscopy.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eDeliberate hypercorrection of the reduction:\u003c\/strong\u003e planned compensation for the expected loss of correction due to soft tissue interposition at the inferior button.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eConcealed knot suturing:\u003c\/strong\u003e technique of folding the excess wire for coverage beneath the muscular plane, optimizing aesthetic and functional outcomes.\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003ch4\u003eINCLUDED MATERIAL\u003c\/h4\u003e\n\u003cp\u003e\u003cstrong\u003eDetailed PDF:\u003c\/strong\u003e document with the complete case analysis, including the step-by-step operative sequence, the biomechanical principles of TightRope fixation at the acromioclavicular joint, and the positioning, fluoroscopy, and post-fixation control protocols used in the procedure.\u003c\/p\u003e\n\u003cp\u003eMaster acromioclavicular dislocation reduction and fixation with TightRope through a real case, documented in detail — enroll now and bring this technique to your surgical practice.\u003c\/p\u003e\n\u003cp\u003e\u003c!-- notionvc: a8465fa1-cf42-4a48-974f-5fe30a916cf3 --\u003e\u003c\/p\u003e","brand":"reconstrucaoossea","offers":[{"title":"Default Title","offer_id":64164725719409,"sku":null,"price":0.0,"currency_code":"BRL","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0911\/4409\/4065\/files\/ACROMIOCLAVICULARCase3_TightRopeFixation.webp?v=1783538824","url":"https:\/\/reconstrucaoossea.com\/es\/products\/acromioclavicular-case-3-tightrope-fixation","provider":"reconstrucaoossea","version":"1.0","type":"link"}