Open distal clavicle resection

Since 1941, resection of the distal clavicle has been a proven treatment for symptomatic acromioclavicular (AC) joint pathology. Although arthroscopic techniques have been well developed, open distal clavicle resection remains the gold standard and in certain patients is the preferred technique for removal of the distal clavicle. A thorough understanding of the historical presentation, physical examination, and radiographic and MRI findings, as well as an appreciation for possible concomitant pathology, is necessary to properly select patients who will benefit from distal clavicle resection. Open distal clavicle resection may be performed expeditiously and at low cost through a cosmetically acceptable small saber-type incision, often in less time than it takes to set up arthroscopic equipment. Results of open distal clavicle resection demonstrate excellent symptomatic relief with low morbidity in properly selected patients. Attention to detail and knowledge of the anatomy of the AC joint is necessary to assure adequate but not excessive bone removal (usually 1 cm), and meticulous preservation of the superior capsule and deltotrapezial fascia allows for an anatomic closure of these stabilizing structures.