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Official Journal of the Italian Society of Orthopaedics and Traumatology

Fig. 5 | Journal of Orthopaedics and Traumatology

Fig. 5

From: Management of chronic unstable acromioclavicular joint injuries

Fig. 5

a Before the ZipTight is tensioned, the graft should be fixed in the clavicular portion of the conoid tunnel with a 4.5- to 5.5-mm (same diameter of the tunnel) bio-tenodesis interference screw. Reproduced with permission and copyright© of Arthroscopy Techniques, Elsevier. b Both limbs of the graft coming out of the clavicle when fixed in both tunnels with bio-tenodesis interference screws. The ZipTight is tied by threading the sliding suture in the washer. To avoid any harm to the sutures of the ZipTight with the screw, the graft should be placed in an intermediate position between the screw and the sutures. c The ZipTight has been tied by pulling alternatively on both limbs of the blue traction sutures in a cranial direction to make the washer go down until it touches the clavicle and self-locks, providing mechanical stabilization of the reconstruction. d Both limbs of the graft are crossed over each other and sutured to themselves. The remnant of the graft is sectioned and removed

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