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Acromioclavicular ligament

K C Kapil-Mani, A Niroula
Introduction: The optimal surgical treatment for acromioclavicular joint (ACJ) injuries remains controversial. The modified Weaver-Dunn (WD) procedure is one of the frequently used techniques. Recently when it was compared with anatomical autogenous tendon graft reconstruction procedures, the results were inferior. However, these anatomical procedures are technically more demanding with small margin of error and they have tendency for postoperative pain because of extra donor site incision. Materials and Methods: Forty patients with type IV to VI ACJ dislocations were treated by modified WD procedure using non-absorbable synthetic suture passed through the base of coracoid process for augmentation of transferred coraco-acromial (CA) ligament...
July 2018: Malaysian Orthopaedic Journal
Ravi Gupta, Munish Sood, Anubhav Malhotra, Gladson David Masih, Tanu Khanna, Mukta Raghav
Background: The debate about the ideal surgical procedure for acromioclavicular joint (ACJ) dislocation is still unresolved and newer techniques are being evolved continuously. The present study evaluates functional outcome of ACJ reconstruction using the modified Weaver Dunn procedure. Materials and Methods: 35 patients (26 males, 9 females) with ACJ dislocation, between the age group of 18-48 years (mean age 31 years), were operated using modified Weaver Dunn procedure at our center from May 2005 to June 2010...
July 2018: Indian Journal of Orthopaedics
Joseph N Liu, Grant H Garcia, K Durham Weeks, Jacob Joseph, Orr Limpisvasti, Edward G McFarland, Joshua S Dines
Despite advancements in surgical technique and understanding of throwing mechanics, controversy persists regarding the treatment of grade III acromioclavicular (AC) joint separations, particularly in throwing athletes. Twenty-eight major league baseball (MLB) orthopedic team physicians were surveyed to determine their definitive management of a grade III AC separation in the dominant arm of a professional baseball pitcher and their experience treating AC joint separations in starting pitchers and position players...
July 2018: American Journal of Orthopedics
Ki Won Lee, Joo-Yul Bae, Dong-Kyo Seo, Jung-Ki Ha, Ho Jong Ra, Joon Hee Kim, Byeong Cheol Ho
Eleven patients with bipolar clavicle injuries, including dislocation of both ends of the clavicle, dislocation of the sternoclavicular joint with distal clavicle fracture, dislocation of the acromioclavicular joint with medial clavicle fracture, and segmental fracture of the clavicle, were retrospectively reviewed. The purpose of this study was to report the clinical outcomes and a literature review of bipolar clavicle injury. Nonoperative treatment was performed for 5 patients and surgical treatment for 6 patients...
July 27, 2018: Orthopedics
Joey A LaMartina, Brian C Lau, Liane Miller, Madeleine A Salesky, Brian T Feeley, C Benjamin Ma, Alan L Zhang
Background: There is no standard method for the surgical treatment of acromioclavicular (AC) joint separations. Current techniques have associated complications, including need for device removal, coracoid fracture, and inadequate reduction. Purpose: To evaluate the clinical outcomes of an internal splint technique without graft augmentation or rigid fixation to treat acute Rockwood type IV and V AC joint injuries. Study Design: Case series; Level of evidence, 4...
July 2018: Orthopaedic Journal of Sports Medicine
Guheng Wang, Renguo Xie, Tian Mao, Shuguo Xing
BACKGROUND: The purpose of this study was to compare outcomes between allograft reconstruction and hook plate fixation for acute dislocation of the acromioclavicular joint with a minimum 2-year follow-up. METHODS: A retrospective comparative study of patients treated for acute acromioclavicular joint dislocation from February 2010 to December 2014 in our hospital, consisting of 16 patients who were followed-up, was performed. Eight patients were treated for acute AC dislocation and underwent surgical reconstruction as follows: the coracoclavicular and acromioclavicular ligaments were reconstructed with the allogenic tendon...
July 11, 2018: Journal of Orthopaedic Surgery and Research
Alexander S North, Tracey Wilkinson
Injuries to the acromioclavicular (AC) joint are common, tending to occur secondary to traumatic injuries. Rockwood grade IV, V and VI injuries involve complete dislocation of the joint and require surgical reconstruction, with inconclusive literature on whether grade III injuries should be surgically or conservatively managed. There are over one hundred reported surgical techniques which reconstruct the AC joint, with little indication of which methods achieve the best results. Techniques can generally be considered as: anatomical reduction; CC ligament reconstruction; and anatomical reconstruction...
August 2018: Strategies in Trauma and Limb Reconstruction
HoeJeong Chung, DooSup Kim, Scott A Banks, JongSang Son, YoungHo Kim, MyoungGi On, JunSeop Yeom
PURPOSE: Acromioclavicular-coracoclavicular ligament injury occurs frequently, and the clavicle hook plate technique is an easy-to-use treatment method. However, complications such as subacromial impingement syndrome, synovitis, erosion, osteolysis, post-operative pain, and post-operative limitations in range of motion have been reported. We aimed to evaluate the use of the clavicle hook plate in the shoulder joints and to compare in vivo three-dimensional (3D) scapular kinematics and scapulohumeral rhythm between the shoulders with a clavicle hook plate and contralateral normal shoulder joints...
June 8, 2018: International Orthopaedics
Radwan G Metwaly, Kareem Edres
Introduction: Acromioclavicular (AC) joint injury associated with coracoid process (CP) fracture is a rare injury and only case reports had been published in the literature. Although AC joint injury is not uncommon, there is controversy as regard the best stabilization method whether to use wires, hook plate, arthroscopic reconstruction or the recently described techniques of anatomic restoration of both the coracoclavicular (CC) and acromioclavicular (AC) ligaments to add stability in both the vertical as well as the horizontal plane for the AC joint...
June 2018: Trauma Case Reports
Mohamed Aboalata, Ahmed Almohandes, Osama Abunar, Moheib S Ahmed, Andreas B Imhoff, Yehia Bassiouny
Avulsion fractures of the tibial eminence, although generally a rare injury pattern, are more common in children and adolescents than in adults. Many open and arthroscopic techniques are available with variable degrees of satisfying results and incidence of complications and adverse effects. Arthroscopic fixation appeared to improve the functional outcomes with fewer complications than the open fixation. New techniques were reported using commercially available suspension sling devices for the acromioclavicular joint that offers an easy and rapid method of fixation...
May 2018: Arthroscopy Techniques
Juha O Ranne, Terho U Kainonen, Jussi A Kosola, Lasse L Lempainen, Kari J Kanto, Janne T Lehtinen
Several techniques have been introduced to treat acromioclavicular separation with coracoclavicular ligament reconstruction using graft augmentation. A modified arthroscopic technique for coracoclavicular ligament reconstruction was used based on a previous technique where the supportive device and tendon graft share the clavicular and coracoid drill holes. A notable problem with the previous technique was large protruding suture knots on the washer and clavicle, which could predispose to wound infection. In this modified technique, titanium implants were introduced...
May 2018: Arthroscopy Techniques
Malo Le Hanneur, Andrew Thoreson, Damien Delgrande, Thibault Lafosse, Jean-David Werthel, Philippe Hardy, Bassem Elhassan
BACKGROUND: Anatomic reconstruction techniques are increasingly used to address cases of acromioclavicular (AC) joint chronic instability. These usually involve an additional surgical site for autograft harvesting or an allograft. PURPOSE: To describe a triple-bundle (TB) anatomic reconstruction using on-site autografts, the semiconjoint tendon (SCT) and the coracoacromial ligament (CAL), and compare its primary stability to the native AC joint ligamentous complex and to a modified Weaver-Dunn (WD) reconstruction...
July 2018: American Journal of Sports Medicine
Julian Mehl, Daichi Morikawa, Augustus D Mazzocca
The coracoid process is the origin of the trapezoid ligament, the deltoid ligament, and the coracoacromial ligament (CAL). Detailed knowledge about their anatomy is crucial for surgical procedures such as the reconstruction of the coracoclavicular ligaments or coracoid transfer. Although the coracoclavicular ligaments are considered important stabilizers of the acromioclavicular joint and are therefore highly protected, the CAL seems less important, which is why it is generally cut during coracoid transfer procedures...
May 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Behrang Amini, Nicholas M Beckmann, Francesca D Beaman, Daniel E Wessell, Stephanie A Bernard, R Carter Cassidy, Gregory J Czuczman, Jennifer L Demertzis, Bennett S Greenspan, Bharti Khurana, Kenneth S Lee, Leon Lenchik, Kambiz Motamedi, Akash Sharma, Eric A Walker, Mark J Kransdorf
Traumatic shoulder pain is pain directly attributed to a traumatic event, either acute or chronic. This pain may be the result of either fracture (the clavicle, scapula, or proximal humerus) or soft-tissue injury (most commonly of the rotator cuff, acromioclavicular ligaments, or labroligamentous complex). Imaging assessment of traumatic shoulder pain begins with conventional radiography and, depending on physical examination findings, will require MRI or MR arthrography for assessment of soft-tissue injuries and CT for delineation of fracture planes...
May 2018: Journal of the American College of Radiology: JACR
Jian Yin, Zhaoyang Yin, Ge Gong, Chao Zhu, Chao Sun, Xinhui Liu
PURPOSE: This study was designed to compare the surgical outcomes of a hook plate with double-tunnel coracoclavicular (CC) ligament reconstruction by conjoined tendon transfer versus single hook plate surgery for the repair of acute type of Rockwood type III and V acromioclavicular (AC) joint dislocations. METHODS: The study cohort included 62 patients with acute (within 6 weeks after trauma) Rockwood type III and V AC joint dislocations who underwent surgery from February 2012 to September 2015...
June 2018: International Journal of Surgery
T M Tiefenboeck, S Boesmueller, D Popp, S Payr, J Joestl, H Binder, M Schurz, M Komjati, C Fialka, R C Ostermann
BACKGROUND: The acromioclavicular (AC) joint is of great importance for shoulder stability and one of the most frequently injured regions of the shoulder. HYPOTHESIS: AC joint reconstruction with the ligament augmentation & reconstruction system (LARS™) leads to a good-to-excellent outcome at long-term follow-up. PATIENTS AND METHODS: This study was performed as a retrospective single-centre data analysis of a level-I trauma centre. All patients treated operatively for an acute AC dislocation with the LARS™ between 2003 and 2013 were included...
March 23, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Gilbert Moatshe, Bradley M Kruckeberg, Jorge Chahla, Jonathan A Godin, Mark E Cinque, Matthew T Provencher, Robert F LaPrade
PURPOSE: To perform a systematic review of the available literature on clinical and radiographic outcomes after surgical treatment for acromioclavicular (AC) joint instability. METHODS: A systematic review was performed according to PRISMA guidelines. Inclusion criteria were AC joint and coracoclavicular (CC) ligament reconstruction outcomes, English language, human studies, more than 10 patients in the study and a 2-year minimum follow-up. Exclusion criteria were animal studies, cadaveric studies, clinical studies without reported follow-up period or patient-reported outcomes, clinical studies of nonoperative treatment, AC reconstructions with concurrent lateral clavicle fracture, editorial articles, abstracts, presentations, reviews, case reports, and surveys...
June 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Sean Baran, Jeffrey G Belisle, Erin K Granger, Robert Z Tashjian
OBJECTIVES: To analyze the functional and radiographic outcomes of anatomic coracoclavicular ligament reconstruction (ACCR) using allograft tendon without interference screw fixation. DESIGN: Retrospective nonrandomized study. SETTING: Level I trauma center (University Hospital). PATIENTS: Seventeen patients (mean age of 44 years) with Rockwood III through V acromioclavicular joint disruptions. Twelve of 17 patients had a primary reconstruction, including 4 patients sustaining their injuries as part of a polytrauma incident...
April 2018: Journal of Orthopaedic Trauma
Felix G E Dyrna, Florian B Imhoff, Andreas Voss, Sepp Braun, Elifho Obopilwe, John M Apostolakos, Daichi Morikawa, Brendan Comer, Andreas B Imhoff, Augustus D Mazzocca, Knut Beitzel
BACKGROUND: The acromioclavicular (AC) capsule is an important stabilizer against horizontal translation and also contributes to the strut function of the clavicle, which guides rotation of the scapula. To best reproduce the biomechanical properties and the complex 3-dimensional (3D) guidance of the AC joint, detailed knowledge of the contribution of each of the distinctive capsular structures is needed. Purpose/Hypothesis: To perform a detailed biomechanical evaluation of the specific capsular structures of the AC joint and their contribution to translational and rotational stability...
May 2018: American Journal of Sports Medicine
James D Wylie, Jeremiah D Johnson, Jessica DiVenere, Augustus D Mazzocca
Injuries to the acromioclavicular joint and coracoclavicular ligaments are common. Many of these injuries heal with nonoperative management. However, more severe injuries may lead to continued pain and shoulder dysfunction. In these patients, surgical techniques have been described to reconstruct the function of the coracoclavicular ligaments to provide stable relationship between the clavicle and scapula. These surgeries have been fraught with high complication rates including clavicle and coracoid fractures, infection, loss of reduction and fixation, hardware migration, and osteolysis...
April 2018: Clinics in Sports Medicine
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