27/10/2025
Presented my proposed extension - Type 7 of the Rockwood classification of ACJ injury complex at the OTA- Phoenix, AZ.
The other image pane is the classic Rockwood classification of the AC joint injuries They are all AC Joint injury patterns. They all depend on the Coraco-clavicular relationship to fail at the two coracoclacvicular ligements.
Pane 3 shows an AC Joint injury with coracoid base avulsion fracture.
These are the same injury mechanisms, just the CC ligaments don’t fail and instead they pull the coracoid with them.
This means you can not fix them by the Coraco-Clavicular interval fixation with buttons like the other commoner AC Joint injury patterns.
The classic Rockwood 3-6 patterns can be treated with coraco-clavicular ineteval fixation with buttons, but when there is coracoid fracture, such button fixation is not possible.
This can be treated with Hook plate effectively instead.
Not realizing this classification pattern and its mechanics leads surgeons to do more complex surgeries like open, percutaneous or endocscopy assisted coracoid-glenoid screw fixation. Understanding this ligament injury pattern allows you to fix this with simpler Hook plate.
This pattern I am proposing to be called a Type 7 or a new Variant of the Rockwood AC Joint injury classification system.
