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Ac joint separation

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
Shuaib Nasser
Asthma deaths are a barometer of the quality of asthma care. The principal care for patients with severe asthma is often a joint partnership between primary and secondary services. Communication between the two services determines the effectiveness of treatment. Undertaking an audit on asthma in either primary or separately in secondary care is a relatively straightforward process. However, when the audit spans both primary and secondary care in a country as large as the United Kingdom which is further sub-divided into the separate healthcare systems of England, Wales, Scotland, and Northern Island, then the audit becomes considerably more challenging...
2016: Respiratory Research
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
Masataka Nakazawa, Akimoto Nimura, Tomoyuki Mochizuki, Masahiro Koizumi, Tatsuo Sato, Keiichi Akita
BACKGROUND: Several biomechanical studies have shown that the acromioclavicular (AC) ligament prevents posterior translation of the clavicle in the horizontal plane. In anatomy textbooks, however, the AC ligament is illustrated as running straight across the AC joint surface. HYPOTHESIS: The AC ligament does not run straight across the joint surface, and the configuration of the AC ligament may vary. STUDY DESIGN: Descriptive laboratory study...
June 17, 2016: American Journal of Sports Medicine
Rachel M Frank, Scott W Trenhaile
Surgical management of acromioclavicular (AC) joint separations remains challenging, especially in the revision setting. Most commonly, Rockwood type I and II injuries are managed nonoperatively whereas type IV, V, and VI injuries are managed with surgery. Type III separations are more controversial, with evidence supporting both nonoperative and operative treatment options. Multiple different arthroscopic techniques have been described; however, there is no current gold standard. AC joint reconstruction with the TightRope device (Arthrex, Naples, FL) with the patient in the lateral decubitus position is a method of restoring joint stability that allows for a minimally invasive, low-profile fixation construct using a single drill hole through the clavicle...
August 2015: Arthroscopy Techniques
Lukas Weiser, Jakob V Nüchtern, Kay Sellenschloh, Klaus Püschel, Michael M Morlock, Johannes M Rueger, Michael Hoffmann, Wolfgang Lehmann, Lars G Großterlinden
PURPOSE: To evaluate different stabilisation techniques for acromioclavicular (AC) joint separations, including direct AC repair, and to compare the properties of the stabilised and native joints. METHODS: An established in vitro testing model for the AC joint was used to analyse joint stability after surgical reconstruction [double TightRope (DTR), DTR with AC repair (DTR + AC), single TR with AC repair (TR + AC), and PDS sling with AC repair (PDS + AC)]...
December 19, 2015: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
O Gastaud, J L Raynier, F Duparc, L Baverel, K Andrieu, N Tarissi, J Barth
INTRODUCTION: The treatment of acromioclavicular (AC) joint separations is controversial, particularly for Rockwood type III injuries. Rockwood type IV injuries, which correspond to horizontal instability, are very likely under-diagnosed. The objective of this study was to evaluate the inter- and intra-observer reproducibility of the Rockwood classification through an evaluation of standard radiographs, as described in the original article. MATERIAL AND METHODS: This was a prospective radiographic study using protocol-based data from the 2014 symposium of the French Society of Arthroscopy (SFA)...
December 2015: Orthopaedics & Traumatology, Surgery & Research: OTSR
Jarret M Woodmass, John G Esposito, Yohei Ono, Atiba A Nelson, Richard S Boorman, Gail M Thornton, Ian Ky Lo
PURPOSE: Over the past decade, a number of arthroscopic or arthroscopically assisted reconstruction techniques have emerged for the management of acromioclavicular (AC) separations. These techniques provide the advantage of superior visualization of the base of the coracoid, less soft tissue dissection, and smaller incisions. While these techniques have been reported to provide excellent functional results with minimal complications, discrepancies exist within the literature. This systematic review aims to assess the rate of complications following these procedures...
2015: Open Access Journal of Sports Medicine
Sally A Corey, William A Agger, Andrew T Saterbak
Acromioclavicular (AC) and sternoclavicular (SC) septic arthritis with contiguous pyomyositis are rare, especially in immunocompetent individuals. We report a case of septic AC joint with pyomyositis of the deltoid and supraspinatus muscles and a separate case with septic SC joint with pyomysitis of the sternocleidomastoid muscle. Both patients had similar presentations of infections with Staphylococcus aureus and were successfully treated with surgical incision and drainage followed by prolonged antibiotic therapy...
March 2015: Clinics in Orthopedic Surgery
Scott T Watson, Douglas J Wyland
BACKGROUND: Treatment of type III acromioclavicular (AC) separations is controversial, especially in the dominant shoulder of a high-level throwing athlete. This case report describes the return to play after nonoperative management of a collegiate baseball pitcher with a severe type III AC separation in his throwing shoulder. HYPOTHESIS/PURPOSE: Case report of return to play with nonoperative management of a type III AC separation in the throwing shoulder of a collegiate pitcher...
February 2015: Physician and Sportsmedicine
Ahmad Fadzil Mohd Hani, Dileep Kumar, Aamir Saeed Malik, Nicolas Walter, Ruslan Razak, Azman Kiflie
RATIONALE AND OBJECTIVES: Quantitative assessment of knee articular cartilage (AC) morphology using magnetic resonance (MR) imaging requires an accurate segmentation and 3D reconstruction. However, automatic AC segmentation and 3D reconstruction from hydrogen-based MR images alone is challenging because of inhomogeneous intensities, shape irregularity, and low contrast existing in the cartilage region. Thus, the objective of this research was to provide an insight into morphologic assessment of AC using multilevel data processing of multinuclear ((23)Na and (1)H) MR knee images...
January 2015: Academic Radiology
M M Schneider, M Balke, P Koenen, M Fröhlich, A Wafaisade, B Bouillon, M Banerjee
PURPOSE: The reliability of the Rockwood classification, the gold standard for acute acromioclavicular (AC) joint separations, has not yet been tested. The purpose of this study was to investigate the reliability of visual and measured AC joint lesion grades according to the Rockwood classification. METHODS: Four investigators (two shoulder specialists and two second-year residents) examined radiographs (bilateral panoramic stress and axial views) in 58 patients and graded the injury according to the Rockwood classification using the following sequence: (1) visual classification of the AC joint lesion, (2) digital measurement of the coracoclavicular distance (CCD) and the horizontal dislocation (HD) with Osirix Dicom Viewer (Pixmeo, Switzerland), (3) classification of the AC joint lesion according to the measurements and (4) repetition of (1) and (2) after repeated anonymization by an independent physician...
July 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
S Metzlaff, S Rosslenbroich, P H Forkel, B Schliemann, H Arshad, M Raschke, W Petersen
PURPOSE: This study was performed to compare the clinical results of a minimally invasive technique for acute acromioclavicular (AC) joint dislocation repair with the traditional hook plate fixation. METHODS: Forty-four patients with an acute (within 2 weeks after trauma) complete AC joint separation (35 male, nine female; median age 36.2 years, range 18-56) underwent surgical repair with either a minimally invasive AC joint repair or a conventional hook plate...
June 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Zhiyong Hou, Jove Graham, Yingze Zhang, Kent Strohecker, Daniel Feldmann, Thomas R Bowen, Wei Chen, Wade Smith
BACKGROUND: Coracoclavicular (CC) ligament reconstruction with semitendinosus tendon (ST) grafts has become more popular and has achieved relatively good results; however optimal reconstruction technique, single-tunnel or two-tunnel, still remains controversial. This paper is to compare the clinical and radiographic data of allogenous ST grafting with single- or two-tunnel reconstruction techniques of the AC joint. METHODS: The outcomes of 21 consecutive patients who underwent anatomical reduction and ST grafting for AC joint separation were reviewed retrospectively...
2014: BMC Surgery
S Braun, F Martetschläger, A B Imhoff
OBJECTIVE: The surgical procedure aims at anatomic reduction and stabilization of the acromioclavicular joint in vertical and horizontal planes for acute separations using a trans-clavicular and trans-coracoidal suture tape fixation with additional acromioclavicular joint augmentation with a PDS cord cerclage. For chronic instability adding a tendon graft is essential for sustainable stability. INDICATIONS: Acute und chronic acromioclavicular joint separations type Rockwood III-VI...
June 2014: Operative Orthopädie und Traumatologie
Tim Saier, Arne J Venjakob, Philipp Minzlaff, Peter Föhr, Filip Lindell, Andreas B Imhoff, Stephan Vogt, Sepp Braun
PURPOSE: To evaluate whether isolated anatomical coracoclavicular (CC) ligament reconstruction with two suture-button devices provides equal horizontal acromioclavicular joint (ACJ) stability compared to additional ACJ suture tape cerclage. METHODS: A servohydraulic testing machine was used to assess horizontal ACJ translation in 12 fresh-frozen human shoulders during 5,000 cycles of dynamic anteroposterior directed loading (70 N). Horizontal ACJ stability was assessed for native specimen (n = 6) and compared to specimen with dissected AC ligaments but intact CC ligaments (n = 6)...
May 2015: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Yeming Wang, Jianguo Zhang
BACKGROUND: Various techniques have been reported for the treatment of chronic acromioclavicular (AC) joint separation. The purpose of this study was to evaluate the results of surgical construction of coracoclavicular ligament using coracoid process transfer augmented with a hook plate fixation. MATERIALS AND METHODS: Twenty-one patients treated with coracoid process transfer augmented with a hook plate fixation for chronic type III and V AC injuries were retrospectively analysed in 2003-2009...
June 2014: Injury
M Schnetzke, S Aytac, P Herrmann, C Wölfl, P A Grützner, V Heppert, T Guehring
BACKGROUND: Posttraumatic and postoperative osteomyelitis (PPO) is a subgroup of bone infections with increasing importance. However, to date no standardized reoperation concept exists particularly for patients with PPO of the shoulder region. Therefore the purpose of this study was to evaluate a revision concept including débridement, irrigation, and insertion of temporary drainage with hardware retention until healing. PATIENTS AND METHODS: A total of 31 patients with PPO were included with a proximal humerus fracture (n = 14), clavicle fracture (n = 10), or AC-joint separation (n = 7)...
June 2015: Der Unfallchirurg
Michael C Glanzmann, Stefan Buchmann, Laurent Audigé, Christoph Kolling, Matthias Flury
INTRODUCTION: Persistent horizontal instability after acute acromioclavicular (AC) joint separation may provoke unsatisfactory results of conservative treatment. HYPOTHESIS: the arthroscopically assisted double flip button stabilization of acute horizontally unstable grade III and IV AC joint disruptions results in full functional restoration and stable radiological reposition. MATERIALS: 21 patients treated for an acute grade III or IV AC joint separation were enrolled...
December 2013: Archives of Orthopaedic and Trauma Surgery
Samantha Huang, Larry J Seidman, Stephanie Rossi, Jyrki Ahveninen
Auditory attention and working memory (WM) allow for selection and maintenance of relevant sound information in our minds, respectively, thus underlying goal-directed functioning in everyday acoustic environments. It is still unclear whether these two closely coupled functions are based on a common neural circuit, or whether they involve genuinely distinct subfunctions with separate neuronal substrates. In a full factorial functional MRI (fMRI) design, we independently manipulated the levels of auditory-verbal WM load and attentional interference using modified Auditory Continuous Performance Tests...
December 2013: NeuroImage
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