Novel 3-point positioning technique combined with the TightRope system for treating acute Rockwood type III acromioclavicular joint dislocation

doi:10.5312/wjo.v17.i5.118475

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Publication Name

World Journal of Orthopedics

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2218-5836

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Orthop. May 18, 2026; 17(5): 118475
Published online May 18, 2026. doi: 10.5312/wjo.v17.i5.118475

Novel 3-point positioning technique combined with the TightRope system for treating acute Rockwood type III acromioclavicular joint dislocation

Fan-You Ning, Hai-Yan Xu, Zi-Long Zhao, Fei-Xiong Chen

Fei-Xiong Chen, Zi-Long Zhao, Hai-Yan Xu, Fan-You Ning, Shoulder and Elbow Surgery, Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital), Luoyang 471000, Henan Province, China

Author contributions: Chen FX, Zhao ZL, Xu HY, and Ning FY contributed to the conception and design of the study; Chen FX and Ning FY performed the research; Zhao ZL and Xu HY revised the study critically for important intellectual content and prepared tables and figures; Chen FX, Zhao ZL, Xu HY, and Ning FY analyzed the data and wrote the manuscript. All authors have read and approved the final manuscript.

Supported by Henan Province Traditional Chinese Medicine Scientific Research Special Project, No. 2023ZY2120.

Institutional review board statement: This study was approved by the Ethics Committee of Luoyang Orthopedic-Traumatological Hospital of Henan Province: Henan Provincial Orthopedic Hospital (No. 2024KYKT0032-01), and it was conducted in accordance with the principles of the Declaration of Helsinki.

Informed consent statement: Informed consent was obtained from all patients.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Data sharing statement: The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

Corresponding author: Fan-You Ning, Shoulder and Elbow Surgery, Luoyang Orthopedic-Traumatological Hospital of Henan Province: Henan Provincial Orthopedic Hospital, No. 18 Qiming South Road, Luoyang 471000, Henan Province, China. ningfanyou@163.com

Received: January 4, 2026
Revised: January 30, 2026
Accepted: March 6, 2026
Published online: May 18, 2026
Processing time: 134 Days and 23.1 Hours

Abstract

BACKGROUND

The TightRope system is a common strategy for treating acute Rockwood type III acromioclavicular joint dislocation (ACJD). However, it requires frequent intraoperative fluoroscopy, which poses potential risks to both patients and operators. A novel 3-point positioning technique was developed to reduce intraoperative fluoroscopy time.

AIM

To evaluate the efficacy of the 3-point positioning technique combined with the TightRope system in acute Rockwood type III ACJD.

METHODS

Between January 2024 and October 2024, 26 patients with acute Rockwood type III ACJD underwent treatment via the 3-point positioning technique combined with the TightRope system. Demographic characteristics, operative parameters, and follow-up data were recorded. Preoperative and postoperative clinical evaluations were performed and compared.

RESULTS

The study included 26 patients, 19 males and 7 females, with a mean age of 41.04 ± 12.93 years. The average intraoperative fluoroscopy time was 8.31 ± 1.54 seconds, and the median follow-up period was 13 months. At the final follow-up, significant improvements in the scores were observed relative to preoperative measurements, with all comparisons yielding statistical significance (P < 0.05). The overall complication rate was 3.85%.

CONCLUSION

The 3-point positioning technique combined with the TightRope system reduces intraoperative fluoroscopy time and provides a safe and effective treatment option for patients with acute Rockwood type III ACJD.

Keywords: Acromioclavicular joint dislocation; 3-point positioning technique; TightRope system; Minimally invasive; Fluoroscopy

Core Tip: The TightRope system is a common treatment strategy for acute Rockwood type III acromioclavicular joint dislocation. Conventional surgery requires frequent intraoperative fluoroscopy, which poses potential risks to both patients and operating personnel. We developed a 3-point positioning technique to reduce intraoperative fluoroscopy time. This method uses a Kirschner wire and surface markings to establish a stable trajectory under fluoroscopic guidance by aligning the Kirschner wire, clavicular tunnel position, and the guidewire in a straight line. This technique facilitates rapid, accurate drilling and implant placement while significantly reducing fluoroscopic time.