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The Mumford procedure, also known as distal clavicle excision or distal clavicle resection, is an orthopedic procedure performed to ameliorate shoulder pain and discomfort by excising the distal (lateral) end of the clavicle.
The distal clavicle is found in 2 orientations, either subacromial or subcoracoid. With the subcoracoid dislocation, the clavicle becomes lodged behind the intact conjoined tendon. The posterior superior AC ligaments, which often remain attached to the acromion, get displaced into the AC interval, making anatomic reduction difficult.
The clavicle, collarbone, or keybone is a slender, S-shaped long bone approximately 6 inches (15 cm) long [1] that serves as a strut between the shoulder blade and the sternum (breastbone). There are two clavicles, one on each side of the body.
Clavicle fractures occur at 30–64 cases per 100,000 a year and are responsible for 2.6–5.0% of all fractures. [15] This type of fracture occurs more often in males. [ 15 ] About half of all clavicle fractures occur in children under the age of seven and is the most common pediatric fracture.
Modern variations of the procedure may use additional fixation methods to better stabilize the distal clavicle end as the original construction is rather weak compared to the unharmed shoulder. Even with these modifications, the modern surgeries do not match intact coracoclavicular ligament strength in cadaveric testing. [ 3 ]
Surgery may be done arthroscopically or as open surgery. The impinging structures may be removed in surgery, and the subacromial space may be widened by resection of the distal clavicle and excision of osteophytes on the under-surface of the acromioclavicular joint. [4] Damaged rotator cuff muscles can be surgically repaired.
The shoulder girdle or pectoral girdle is the set of bones in the appendicular skeleton which connects to the arm on each side. In humans, it consists of the clavicle and scapula; in those species with three bones in the shoulder, it consists of the clavicle, scapula, and coracoid.
The human shoulder is made up of three bones: the clavicle (collarbone), the scapula (shoulder blade), and the humerus (upper arm bone) as well as associated muscles, ligaments and tendons. The articulations between the bones of the shoulder make up the shoulder joints.