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Ac dislocation

Naveen Sharma, Avinash Mandloi, Ashish Agrawal, Shailendra Singh
INTRODUCTION: The clavicle, humerus and acromioclavicular (AC) joint separately are very commonly involved in traumatic injuries around the shoulder. Acromioclavicular joint dislocation with distal clavicle fracture is a well recognized entity in clinical practice. AC joint dislocation with mid shaft clavicle fracture is uncommon and only few cases have been reported in literature. However, to the best of our knowledge, this is the first case report to describe an acromioclavicular dislocation with ipsilateral mid shaft clavicle, mid shaft humerus and coracoid process fracture...
April 2016: Journal of Orthopaedic Case Reports
José Antonio Cano-Martínez, Gregorio Nicolás-Serrano, Julio Bento-Gerard, Francisco Picazo-Marín, Josefina Andrés-Grau
OBJECTIVE: Describe the clinical and radiological results of triple button device in the treatment of high-grade AC dislocations (Rockwood, type V) and assess whether improves vertical and horizontal stability compared to the techniques previously described. MATERIAL AND METHODS: This retrospective study included 39 patients with type V acromioclavicular dislocations treated with Twin Tail TightRope™ system (triple button device). Of the 39 patients, 33 (26 men and 7 women) were able to participate in clinical and radiographic follow up...
September 15, 2016: Injury
Chuncheng Gong, Kuang He, Qu Chen, Alex W Robertson, Jamie H Warner
We use an in situ heating holder within an aberration corrected transmission electron microscope (AC-TEM) to study the structure and dynamics of large closed grain boundary (GB) loops in graphene at the atomic level. Temperatures up to 800 °C are used to accelerate dynamic evolution of the defect clusters, increasing bond rotation and atomic addition/loss. Our results show that the large closed GB loops relax under electron beam irradiation into several isolated dislocations far apart from each other. Line defects composed of several adjacent excess-atom clusters can be found during the reconfiguration process...
September 23, 2016: ACS Nano
Dirk Maier, Martin Jaeger, Kilian Reising, Matthias J Feucht, Norbert P Südkamp, Kaywan Izadpanah
BACKGROUND: Horizontal instability impairs clinical outcome following acute acromioclavicular joint (ACJ) reconstruction and may be caused by insufficient healing of the superior acromioclavicular ligament complex (ACLC). However, characteristics of acute ACLC injuries are poorly understood so far. Purposes of this study were to identify different ACLC tear types, assess type-specific prevalence and determine influencing cofactors. METHODS: This prospective, cross-sectional study comprised 65 patients with acute-traumatic Rockwood-5 (n = 57) and Rockwood-4 (n = 8) injuries treated operatively by means of mini-open ACJ reduction and hook plate stabilization...
2016: BMC Musculoskeletal Disorders
Nai-Feng Zhu, Bi-Yu Rui, Yun-Long Zhang, Yun-Feng Chen
BACKGROUND: There has been a trend to reconstruct the coracoclavicular (CC) ligaments anatomically for management of acromioclavicular (AC) joint dislocations. PURPOSE: The aim of this study was to determine the location and orientation of the CC ligaments for anatomic reconstruction of the AC joint. METHODS: The subjects were a total of 40 shoulders from 20 Chinese cadavers. Two K-wires were drilled through the insertion center of the conoid and trapezoid ligaments respectively...
August 27, 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Felix Porschke, Marc Schnetzke, Sara Aytac, Stefan Studier-Fischer, Paul Alfred Gruetzner, Thorsten Guehring
PURPOSE: Sports activity after surgical AC joint stabilisation has not been comprehensively evaluated to date. The aim of this study was to determine rate, level and time to return to sports after AC joint stabilisation and to identify the influence of overhead sports on post-operative sports activity. METHODS: In this retrospective case series, a total of 68 patients with a high-grade AC joint dislocation (Rockwood type V) were stabilised using a single TightRope technique...
August 26, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Lane N Rush, Nicholas Lake, Eric C Stiefel, Edward R Hobgood, J Randall Ramsey, Michael J O'Brien, Larry D Field, Felix H Savoie
BACKGROUND: Numerous techniques have been used to treat acromioclavicular (AC) joint dislocation, with anatomic reconstruction of the coracoclavicular (CC) ligaments becoming a popular method of fixation. Anatomic CC ligament reconstruction is commonly performed with cortical fixation buttons (CFBs) or tendon grafts (TGs). PURPOSE: To report and compare short-term complications associated with AC joint stabilization procedures using CFBs or TGs. STUDY DESIGN: Cohort study; Level of evidence, 3...
July 2016: Orthopaedic Journal of Sports Medicine
Michael D McKee
PURPOSE: The optimal treatment for acute dislocation of the acromioclavicular (AC) joint remains unclear, and prior randomized trials did not reveal any significant improvements in the operative groups. However, it is clear that some patients treated nonoperatively are dissatisfied with their outcome and request surgical correction. This video demonstrates one method of repair of a chronic dislocation of the AC joint in a patient with significant symptomatology following nonoperative treatment of a high-grade AC dislocation...
August 2016: Journal of Orthopaedic Trauma
Holger Godry, Mustafa Citak, Matthias Königshausen, Thomas A Schildhauer, Dominik Seybold
In case of patients with spinal cord injury and concomitant acromioclavicular (AC) joint-dislocation the treatment is challenging, as in this special patient group the function of the shoulder joint is critical because patients depend on the upper limb for mobilization and wheelchair-locomotion. Therefore the goal of this study was to examine, if the treatment of chronic AC-joint dislocation using the Weaver-Dunn procedure augmented with a hook-plate in patients with a spinal cord injury makes early postoperative wheelchair mobilization and the wheelchair transfer with full weight-bearing possible...
June 27, 2016: Orthopedic Reviews
Alisara Arirachakaran, Manusak Boonard, Peerapong Piyapittayanun, Vajarin Phiphobmongkol, Kornkit Chaijenkij, Jatupon Kongtharvonskul
Treatment of acute (≤4 weeks) high-grade acromioclavicular (AC) joint separation (types III-VI) is still controversial. Currently, the two modern techniques that are widely used include hook plate fixation and coracoclavicular (CC) ligament fixation using a suspensory loop device (tightrope, synthetic ligament or absorbable polydioxansulfate sling). These techniques are both reported to have superior clinical outcomes. This systematic review and meta-analysis aimed to assess and compare clinical outcomes of hook plate fixation versus fixation of the CC ligament using a loop suspensory fixation (LSF) device for the treatment of AC joint injury...
August 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Bruce Matchin, Bruce Yee, Timothy Mott
When not considering the grade of acromioclavicular (AC) joint dislocation, both conservative and surgical management lead to positive outcomes, although surgically managed patients require more time out of work.
April 2016: Journal of Family Practice
Khalid D Mohammed, Danielle Stachiw, Alex A Malone
This reports presents the case of a combined clavicle fracture malunion and chronic Type IV acromioclavicular (AC) joint dislocation. The patient was seen acutely in the emergency department following a mountain bike accident at which time the clavicle fracture was identified and managed conservatively however the AC dislocation was not diagnosed. The patient presented 25 months following the injury with persistent pain and disability and was treated with clavicle osteotomy and AC stabilization. We document the clinical details, surgical treatment and outcome...
January 2016: International Journal of Shoulder Surgery
Chul-Hyun Cho, Beom-Soo Kim, Doo-Hyun Kwon
INTRODUCTION: We evaluated the outcomes of coracoclavicular (CC) augmentation using a suture button device with additional temporary pin fixation for acute acromioclavicular (AC) joint dislocation. MATERIALS AND METHODS: Thirty-six consecutive cases who underwent CC augmentation using TightRope™ (Arthrex, Naples, FL, USA) were included. We temporarily fixed trans-articular pins in the first 10 cases (TA group) and a trans-spine pin in the next 26 cases (TS group)...
June 2016: Archives of Orthopaedic and Trauma Surgery
J Kany, R Guinand, P Croutzet
UNLABELLED: Few salvage procedures have been described after a failed Weaver-Dunn procedure. We hypothesized that it was possible to perform an all-arthroscopic revision with a reflected vascularized conjoint tendon into the distal resected clavicle (Vargas procedure) augmented by an artificial coraco-clavicular ligament. Two patients were enrolled. A minimum of 3-cm proximal conjoint tendon was dissected under arthroscopic control. The half-longitudinal conjoint tendon split, leaving its proximal end attached to the coracoid process, was made and incised transversely near the muscles fibers...
September 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Ahmed Kotb, Taylor Yong, Amr Abdelgawad
Fractures of the lateral end of the clavicle are common in pediatric patients; most of these fractures occur at the physeal level representing Salter Harris injuries. The vast majority of fractures of the lateral end of the clavicle are managed nonoperatively. In this report, we describe a unique type of fracture of the distal end of the clavicle in the pediatric patients in which the fracture occurs in the metaphyseal lateral clavicle with the proximal edge of the fracture displaced posteriorly through the trapezius muscle causing obvious deformity...
2016: Case Reports in Orthopedics
Ali Torkaman, Abolfazl Bagherifard, Tahmineh Mokhatri, Mohammad Hossein Shabanpour Haghighi, Siamak Monshizadeh, Hamid Taraz, Amin Hasanvand
BACKGROUND: Surgical treatments for acromioclavicular (AC) joint dislocation present with some complications. The present study was designed to evaluate the double-button fixation system in the management of acute acromioclavicular joint dislocation. METHODS: This cross sectional study, done between February 2011 to June 2014, consisted of 28 patients who underwent surgical management by the double-button fixation system for acute AC joint dislocation. Age, sex, injury mechanism, dominant hand, side with injury, length of follow up, time before surgery, shoulder and hand (DASH), constant and visual analogue scale (VAS) scores, and all complications of the cases during the follow up were recorded...
January 2016: Archives of Bone and Joint Surgery
C C Drijfhout van Hooff, R Haverlag, W J Willems
PURPOSE: For most types of acromioclavicular (AC) injuries, treatment is well established. For Neer type 2 lateral clavicle fractures and Rockwood types 3-5 AC dislocations, the ideal treatment is still a point of debate. The purpose of this study was to evaluate the functional and radiological outcome in patients treated for one of these two lesions in our hospital. METHODS: Our study group consisted of 30 patients with a Neer type 2 lateral clavicle fracture (n = 19) or Rockwood types 3-5 AC dislocation (n = 11) treated with the clavicle hook plate...
December 2013: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Gang Ye, Chao-An Peng, Hua-Bin Sun, Jing Xiao, Kang Zhu
BACKGROUND: The aim of this study was to evaluate the therapeutic effect of autogenous semitendinosus graft and endobutton technique, and compare with hook plate in treatment of Rockwood type III acromioclavicular (AC) joint dislocation. METHODS: From April 2012 to April 2013, we treated 46 patients with Rockwood type III AC joint dislocation. Patients were randomly divided into two groups: Group A was treated using a hook plate and Group B with autogenous semitendinosus graft and endobutton technique...
2016: Therapeutics and Clinical Risk Management
Jong Pil Yoon, Yeon Soo Lee, Geun Soo Song, Joo Han Oh
PURPOSE: Acromioclavicular (AC) joint dislocation is a common sports injury. Hook plate fixation is currently widely used to treat this injury, as it can promote the natural healing of the ligament with good clinical outcomes. However, subacromial erosion and impingement are frequently observed post-operatively. It was hypothesized that the morphology and the contact characteristics between the hook portion and the acromion are the main causes of complications after hook plate fixation with the currently available commercial designs...
January 20, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Deepak Chaudhary, Vineet Jain, Deepak Joshi, Jitesh Kumar Jain, Ankit Goyal, Nitin Mehta
PURPOSE: To review outcome after arthroscopic fixation for acute acromioclavicular (AC) joint dislocation using the TightRope device. METHODS: Records of 15 men and 2 women aged 19 to 52 (mean, 35) years who underwent arthroscopic fixation using the TightRope device for acute (<3 weeks) AC joint dislocation of Rockwood type III (n=6), type IV (n=1), and type V (n=10) were reviewed. Outcome was evaluated using the Constant score. The coracoclavicular (CC) distance before and after surgery was compared...
December 2015: Journal of Orthopaedic Surgery
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