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distal clavicle excision

Sho Okimatsu, Hiroto Kamoda, Tsukasa Yonemoto, Shintaro Iwata, Takeshi Ishii
Clavicula pro humero (CPH) reconstruction is a method that is used after proximal humeral excision. During CPH reconstruction, the ipsilateral clavicle is rotated downward and connected to the preserved distal humerus by using plates and screws. This method is frequently used for reconstruction surgeries involving young patients and has positive outcomes. In this study, we describe two cases of CPH reconstruction that were performed on elderly individuals after wide resection of the proximal humerus; postoperative results from these surgeries were satisfactory...
2016: Case Reports in Oncological Medicine
Jordan C Villa, Jelle P van der List, Elizabeth B Gausden, Dean G Lorich, David L Helfet, Peter Kloen, David S Wellman
INTRODUCTION: The optimal treatment for distal clavicle nonunions remains unknown. Small series have reported outcomes following distal fragment excision and various fixation techniques. We present the clinical, radiographic and functional outcomes after superior plating or double (superior and anteroinferior) plating in combination with bone grafting as treatment for distal clavicle nonunions. METHODS: We collected demographic and radiographic data from a consecutive series of ten patients with symptomatic nonunion of the distal clavicle treated since 1998...
November 2016: Archives of Orthopaedic and Trauma Surgery
Tae-Soo Park, Kwang-Won Lee
BACKGROUND: Symptomatic acromioclavicular joint (ACJ) lesions are a common cause of shoulder complaints that can be treated successfully with both conservative and surgical methods. There are several operative techniques, including both open and arthroscopic surgery, for excising the distal end of the clavicle. Here, we present a new modified arthroscopic technique for painful osteoarthritis of the ACJ and evaluate its clinical outcomes. Our hypothesis was that 4- to 7-mm resection of the distal clavicle in an en bloc fashion would have several advantages, including no bony remnants, maintenance of stability of the ACJ, and reduced prevalence of heterotopic ossification, in addition to elimination of the pathologic portion of the distal clavicle...
July 2016: Indian Journal of Orthopaedics
Dean Wang, Benjamin E Bluth, Chad R Ishmael, Jeremiah R Cohen, Jeffrey C Wang, Frank A Petrigliano
PURPOSE: Prior studies have reported high complication rates with acromioclavicular joint reconstruction (ACJR). However, many of these reports have suffered from small sample sizes and inclusion of older surgical techniques. The purpose of this study was to determine the rates of early complications requiring reoperation in patients treated with ACJR. METHODS: From 2007 to 2011, patients who were treated with ACJR were identified using the PearlDiver database, a large insurance database in the USA...
June 16, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Arnaldo Amado Ferreira Neto, Cassio Silva Trevizani, Eduardo Benegas, Eduardo Angeli Malavolta, Mauro Emílio Conforto Gracitelli, Alexandre Carneiro Bitar, Francisco José Dos Santos Neto
UNLABELLED: To evaluate the clinical and radiographic results from arthroscopic surgical treatment of the rotator cuff in patients with calcifying tendinitis. METHOD: A retrospective study was conducted on twenty patients who underwent arthroscopic treatment for calcifying tendinitis of the shoulder between March 1999 and November 2005. Six patients were excluded due to loss of follow-up. The average follow-up period was 41.4 months. Eight patients (57%) were female and six (43%) were male...
September 2010: Revista Brasileira de Ortopedia
K Gokkus, M Saylik, H Atmaca, E Sagtas, A T Aydin
INTRODUCTION: Resection of the distal aspect of clavicle has a well-documented treatment modality in case of acromioclavicular joint osteoarthritis resistant to conservative treatment. HYPOTHESIS: Limited (mean ∼0.5cm distal end of clavicle resection) distal clavicle excision of A-C joint arthritis in cases resistant to conservative treatment may reduce the pain and improve the shoulder function. MATERIAL AND METHODS: In this study, we retrospectively evaluated the results of limited distal clavicle excision of acromioclavicular joint osteoarthritis resistant to conservative treatment...
May 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Nathaniel Hiscock, Simon Bell, Jennifer Coghlan
BACKGROUND: The surgical repair of shoulder pathologies, including rotator cuff disease and acromio-clavicular joint arthritis, have undergone many technical advances. However the debilitating postoperative stiff shoulder remains a common and significant complication of these surgeries, occurring in 4.9 to 23.2 % of patients undergoing rotator cuff repairs. The pathology of the pathological postoperative stiff shoulder and its associated condition "frozen shoulder" are poorly understood and both lack formal objective clinical diagnostic criteria...
December 4, 2015: BMC Musculoskeletal Disorders
Karl A Illig, Wesley Gabbard, Aurelia Calero, Charles Bailey, Murray Shames, Paul Armstrong, Peter R Nelson
BACKGROUND: A substantial number of patients with threatened arteriovenous (AV) access are found to have stenoses at the costoclavicular junction (CCJ), which frequently are resistant to angioplasty and stenting. We believe that stenoses in this location will not resolve unless bony decompression is performed to relieve the extrinsic compression on the vein. This article describes our short- to medium-term results following such decompression in patients with failing fistulae. METHODS: We reviewed a prospectively maintained database to identify all patients with threatened AV access operated on for stenoses at the CCJ...
2015: Annals of Vascular Surgery
Bradley S Tragord, Liem T Bui-Mansfield, Theodore Croy, Scott W Shaffer
STUDY DESIGN: Resident's case problem. BACKGROUND: Acromioclavicular joint pathology is reported to be present in up to 30% of all patients complaining of shoulder dysfunction. The operative approach to treating acromioclavicular joint disease often includes a distal clavicle excision and, in circumstances of acromioclavicular joint instability, reconstruction of the coracoclavicular and/or the acromioclavicular ligament. Surgical complications for these procedures are rare, but potentially include suprascapular neuropathy secondary to the course of the suprascapular nerve posterior to the clavicle prior to entering the supraspinatus fossa...
April 2015: Journal of Orthopaedic and Sports Physical Therapy
Hz Chan, Cl Ooi, My Lim, Eks Ong, O Zulkiflee
ABSTRACT: Shoulder impingement syndrome and acromioclavicular joint osteoarthritis often occur simultaneously and easily missed. Kay et al. reported excellent results with combined arthroscopic subacromial decompression and resection of the distal end of the clavicle in patients with both disorders(1). Arthroscopic treatment of these disorders produces more favourable results than open procedures. We report two patients who were not responding to conservative management and were treated with direct arthroscopic distal clavicle excision and subacromial decompression in single setting...
July 2014: Malaysian Orthopaedic Journal
Brian G Webb, Michael P Elliott
Arthroscopic shoulder surgery is considered a safe and effective method of treating a variety of shoulder pathologies and is associated with a low complication rate. The type and rate of complications can vary, depending on the procedure, positioning, surgical time, and anesthesia. Fortunately, neurovascular injuries occur infrequently. Numerous studies have described the proximity of neurovascular structures to portals placed in shoulder arthroscopy, in both the beach chair and the lateral decubitus positions...
June 2014: Orthopedics
Ram K Alluri, Asher I Kupperman, Scott R Montgomery, Jeffrey C Wang, Sharon L Hame
PURPOSE: The purpose of this study was to evaluate and quantify the demographic characteristics of patients undergoing open and arthroscopic distal clavicle excision (DCE) in the United States while also describing changes in practice patterns over time. METHODS: Patients who underwent DCE from 2004 to 2009 were identified by Current Procedural Terminology (CPT) codes in a national database of orthopaedic insurance records. The year of procedure, age, sex, geographic region, and concomitant rotator cuff repair or subacromial decompression (SAD) were recorded for each patient...
September 2014: Arthroscopy: the Journal of Arthroscopic & related Surgery
Filon Agathangelidis, Achilleas Boutsiadis, Evangelia Fouka, Dimitrios Karataglis
A 48-year-old man was being treated unsuccessfully for miliary tuberculosis for 5 months until he presented with acromioclavicular joint swelling. Imaging of the shoulder revealed destruction of the acromioclavicular joint and the patient was brought to the operating theatre and underwent the excision of the distal end of the clavicle, synovectomy and drainage of the abscess. Surgery was followed by prompt clinical, functional and radiological improvement. Histopathology confirmed the diagnosis of acromioclavicular tuberculosis...
June 21, 2013: BMJ Case Reports
Andrew B Beaver, Brent G Parks, Richard Y Hinton
BACKGROUND: Acromioclavicular (AC) joint separation is a common injury, usually affecting young adults. Controversy exists regarding whether to excise the distal clavicle when surgical intervention is required. PURPOSE: To evaluate the biomechanical strength of AC and coracoclavicular (CC) ligament reconstruction with and without concurrent distal clavicle excision. STUDY DESIGN: Controlled laboratory study. METHODS: Nine matched pairs of cadaver shoulders were used...
July 2013: American Journal of Sports Medicine
Oliver D Stone, S J Breusch
Hemiarthroplasty of the shoulder can be a safe and an effective treatment for pain in patients with rheumatoid arthritis. Many complications have been previously described in the literature; the most common of which are dislocation, loosening, periprosthetic fractures, and infection. We report a patient who presented with a discharging sinus over the tip of the acromium which was created by the displacement of the prosthesis and erosion of the AC joint and distal clavicle. The erosion of the distal clavicle and AC joint caused the remaining proximal clavicle to become mobile and displaced posteriorly; this spike of clavicle was then able to penetrate the trapezius muscle and eventually the skin causing an aseptic sinus...
2013: Case Reports in Rheumatology
Francois Hardeman, Karin Van Rooyen, Jan Somers, Stefan Doll, Robert Page, Joe De Beer
The purpose of this study was to compare the stability and force of ultimate failure of the acromioclavicular joint (ACJ) after direct arthroscopic distal clavicle excision (DCE) through superior portals and indirect arthroscopic DCE through inferior portals in paired cadaveric shoulders. Ten paired saline-embalmed cadaveric shoulders were operated alternatively using the indirect and direct technique. Biomechanical testing was performed in the horizontal plane, testing displacement at 15N and 30N and finally failure strength was measured testing the constructs until failure occurred...
February 2013: Acta Orthopaedica Belgica
Emery C Lin, Nathan A Mall, Aman Dhawan, Seth L Sherman, Kevin C McGill, Matthew T Provencher, Gregory P Nicholson, Brian J Cole, Daniel J Solomon, Nikhil N Verma, Anthony A Romeo
PURPOSE: The purpose of this study was to evaluate the mechanism of injury, patient characteristics, tear size, and clinical outcomes after arthroscopic primary rotator cuff repair of full-thickness tears in patients aged younger than 45 years. METHODS: A total of 70 consecutive patients were reviewed in a retrospective, multicenter (2 institutions) study evaluating prospectively collected data. Fifty-three patients, with a mean age of 37.5 years (range, 16.2 to 44...
May 2013: Arthroscopy: the Journal of Arthroscopic & related Surgery
Matthew T Provencher, Frank McCormick, Christopher Dewing, Sean McIntire, Daniel Solomon
BACKGROUND: There is a paucity of type 2 superior labrum anterior and posterior (SLAP) surgical outcomes with prospective data. PURPOSE: To prospectively analyze the clinical outcomes of the arthroscopic treatment of type 2 SLAP tears in a young, active patient population, and to determine factors associated with treatment success and failure. STUDY DESIGN: Case-control study; Level of evidence, 3. METHODS: Over a 4-year period, 225 patients with a type 2 SLAP tear were prospectively enrolled...
April 2013: American Journal of Sports Medicine
Jason A Grassbaugh, Chad Cole, Kurt Wohlrab, Josef Eichinger
Optimal treatment for acromioclavicular (AC) dislocation is unknown. Numerous surgical procedures for AC injuries have been described with little comparison. This study sought to compare the clinical and radiographic results of various surgical techniques in order to identify the optimal surgical technique. Ninety patients met inclusion criteria of AC reconstruction at this institution. A retrospective review of outcomes was performed using the electronic records system. Radiographs were measured for pre- and postoperative grade and percent elevation versus the contralateral side...
2013: Journal of Surgical Orthopaedic Advances
Nikhil G Pandhi, Amanda O Esquivel, Jason D Hanna, David W Lemos, Jeffrey S Staron, Stephen E Lemos
BACKGROUND: Treatment for acromioclavicular (AC) joint pain may include distal clavicle excision (DCE). It is possible that DCE can disrupt the surrounding ligaments, leading to increased AC joint laxity. PURPOSE: To determine the load to failure and stiffness of the AC joint after DCE and symmetric acromioclavicular joint resection (ACJR). STUDY DESIGN: Controlled laboratory study. METHODS: Specimens were randomly assigned to 1 of 2 groups: 1-cm DCE (n = 10) or symmetric (5-mm excision of acromion and distal clavicle) ACJR (n = 10)...
February 2013: American Journal of Sports Medicine
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