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https://www.readbyqxmd.com/read/28275882/management-of-chronic-unstable-acromioclavicular-joint-injuries
#1
REVIEW
Luis Natera Cisneros, Juan Sarasquete Reiriz
The acromioclavicular joint represents the link between the clavicle and the scapula, which is responsible for the synchronized dynamic of the shoulder girdle. Chronic acromioclavicular joint instability involves changes in the orientation of the scapula, which provokes cinematic alterations that might result in chronic pain. Several surgical strategies for the management of patients with chronic and symptomatic acromioclavicular joint instability have been described. The range of possibilities includes anatomical and non-anatomical techniques, open and arthroscopy-assisted procedures, and biological and synthetic grafts...
March 8, 2017: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/28236179/post-operative-outcomes-and-complications-of-suspensory-loop-fixation-device-versus-hook-plate-in-acute-unstable-acromioclavicular-joint-dislocation-a-systematic-review-and-meta-analysis
#2
REVIEW
Alisara Arirachakaran, Manusak Boonard, Peerapong Piyapittayanun, Wichan Kanchanatawan, Kornkit Chaijenkij, Akom Prommahachai, Jatupon Kongtharvonskul
BACKGROUND: Treatment of acute (≤3 weeks) acromioclavicular joint dislocation type III-VI is still controversial. Currently, the two modern techniques that are widely used are hook plate (HP) fixation and coracoclavicular ligament fixation using a suspensory loop device that consists of either a tightrope (single or double), endo-button (single or double), or synthetic ligament and absorbable polydioxansulfate sling. MATERIALS AND METHODS: This systematic review was conducted according to the PRISMA guidelines...
February 25, 2017: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/28210644/axial-plane-biomechanical-evaluation-of-2-suspensory-cortical-button-fixation-constructs-for-acromioclavicular-joint-reconstruction
#3
REVIEW
Steven Struhl, Theodore S Wolfson, Frederick Kummer
BACKGROUND: Although numerous suture-button fixation techniques for acromioclavicular (AC) joint reconstruction have been validated with biomechanical testing in the superior direction, clinical reports continue to demonstrate high rates of construct slippage and breakage. PURPOSE: To compare the stability of a novel closed-loop double Endobutton construct with a commercially available cortical button system in both the axial and superior directions. STUDY DESIGN: Controlled laboratory study...
December 2016: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28194498/lateral-clavicle-fracture-with-coracoclavicular-ligament-injury-a-biomechanical-study-of-4-different-repair-techniques
#4
Farhang Alaee, John Apostolakos, Hardeep Singh, Christian Holwein, Theresa Diermeier, Mark P Cote, Knut Beitzel, Andreas B Imhoff, Augustus D Mazzocca, Andreas Voss
PURPOSE: To investigate the biomechanical performance of four different methods used for coracoclavicular (CC) ligament reconstruction in a lateral clavicle fracture repair. METHODS: Native displacement, translation, and rotation at the acromioclavicular joint of 24 fresh-frozen cadaveric shoulders were tested. A reproducible fracture in the lateral third of the clavicle was created by dissecting both CC ligaments. Each specimen was then repaired with plate fixation of the fracture and the following CC repair technique: (1) Cortical button...
February 14, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28185130/frequency-of-shoulder-corticosteroid-injections-for-pain-and-stiffness-after-shoulder-surgery-and-their-potential-to-enhance-outcomes-with-physiotherapy-a-retrospective-study
#5
John G Skedros, Micheal G Adondakis, Alex N Knight, Michael B Pilkington
INTRODUCTION: What is the rate of injecting patients with shoulder corticosteroid injections to alleviate excessive stiffness and pain within 6 months after shoulder surgery? METHODS: Retrospective 10-year review of a shoulder surgeon's practice. Participants included 754 patients who had 945 non-arthroplasty shoulder surgeries. Outcome measures included the rate of injections, diagnoses, patient characteristics, and efficacy via questionnaire. RESULTS: Approximately one in five patients received a subacromial and/or glenohumeral corticosteroid injection...
February 9, 2017: Pain and Therapy
https://www.readbyqxmd.com/read/28163268/a-case-report-of-an-acromioclavicular-joint-ganglion-associated-with-a-rotator-cuff-tear
#6
Suguru Tanaka, Masafumi Gotoh, Yasuhiro Mitsui, Isao Shirachi, Takahiro Okawa, Fujio Higuchi, Naoto Shiba
We report a case of subcutaneous ganglion adjacent to the acromioclavicular joint with massive rotator cuff tear [1-7]. An 81-year-old woman presented with a ganglion adjacent to the acromioclavicular joint that had first been identified 9 months earlier. The ganglion had recurred after having been aspirated by her local physician, so she was referred to our hospital. The puncture fluid was yellowish, clear and viscous. Magnetic resonance imaging identified a massive rotator cuff tear with multi- lobular cystic lesions continuous to the acromioclavicular joint, presenting the "geyser sign"...
February 6, 2017: Kurume Medical Journal
https://www.readbyqxmd.com/read/28149720/arthroscopically-assisted-acromioclavicular-and-coracoclavicular-ligament-reconstruction-for-chronic-acromioclavicular-joint-instability
#7
Frank Martetschläger, Mark Tauber, Peter Habermeyer, Nael Hawi
Acromioclavicular (AC) joint injuries are common injuries, especially in the young and active, male population. AC joint injuries account for 12% of all injuries of the shoulder girdle in the overall population. Although conservative treatment is recommended for Rockwood type I and type II injuries, there is controversial debate about optimal treatment for type III injuries. High-grade injuries are typically treated operatively to avoid painful sequelae. A vast number of different surgical methods have been described over the past few decades...
December 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28149190/prefered-surgical-technique-used-by-orthopedists-in-acute-acromioclavicular-dislocation
#8
Alexandre Yukio Nishimi, Demetrio Simão Arbex, Diogo Lucas Campos Martins, Carlos Vinicius Buarque DE Gusmão, Roberto Rangel Bongiovanni, Luciano Pascarelli
OBJECTIVE: To determine whether training on shoulder and elbow surgery influences the orthopedist surgeons' preferred technique to address acute acromioclavicular joint dislocation (ACD). METHODS: A survey was conducted with shoulder and elbow specialists and general orthopedists on their preferred technique to address acute ACD. RESULTS: Thirty specialists and forty-five general orthopedists joined the study. Most specialists preferred the endobutton technique, while most general orthopedists preferred the modified Phemister procedure for coracoclavicular ligament repair using anchors...
September 2016: Acta Ortopedica Brasileira
https://www.readbyqxmd.com/read/28097386/biomechanical-analysis-of-clavicle-hook-plate-implantation-with-different-hook-angles-in-the-acromioclavicular-joint
#9
Li-Kun Hung, Kuo-Chih Su, Wen-Hsien Lu, Cheng-Hung Lee
PURPOSE: A clavicle hook plate is a simple and effective method for treating acromioclavicular dislocation and distal clavicle fractures. However, subacromial osteolysis and peri-implant fractures are complicated for surgeons to manage. This study uses finite element analysis (FEA) to investigate the post-implantation biomechanics of clavicle hook plates with different hook angles. METHODS: This FEA study constructed a model with a clavicle, acromion, clavicle hook plate, and screws to simulate the implantation of clavicle hook plates at different hook angles (90°, 95°, 100°, 105°, and 110°) for treating acromioclavicular joint dislocations...
January 18, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28062098/midshaft-clavicle-fractures-with-associated-ipsilateral-acromioclavicular-joint-dislocations-incidence-and-risk-factors
#10
Christina Ottomeyer, Benjamin C Taylor, Mark Isaacson, Lara Martinez, Pierce Ebaugh, Bruce G French
INTRODUCTION: Simultaneous ipsilateral clavicle and acromioclavicular (AC) joint injury have been infrequently reported in the literature at this time. The purpose of this study was to assess incidence as well as assess risk factors for this dual injury pattern. METHODS: We performed a retrospective review of a prospectively collected database (Level III evidence), evaluating 383 adult patients without previous shoulder girdle injury or trauma with a minimum 1-year follow-up who sustained a displaced diaphyseal clavicle fracture...
February 2017: Injury
https://www.readbyqxmd.com/read/28054147/prevalence-of-remaining-horizontal-instability-in-high-grade-acromioclavicular-joint-injuries-surgically-managed
#11
Luis Natera Cisneros, Juan Sarasquete Reiriz
PURPOSE: To determine the prevalence of remaining horizontal instability in high-grade acromioclavicular joint (ACJ) injuries surgically managed by means of four different surgical strategies and to assess its relation to the clinical outcomes and the quality of life. METHODS: In this multicentric non-randomized retrospective study, 53 patients with high-grade ACJ injuries surgically managed (by means of open or arthroscopic surgery) were clinically and radiographically assessed at 24 months or more after shoulder surgery...
January 5, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28052220/acromioclavicular-joint-separation
#12
M Enes Kayaalp, Ali Seker
A 30-year-old man visited the emergency department after a fall that had resulted from a loss of balance while he was walking that day. The patient recalled that he had sustained the impact of the fall on his left shoulder. On examination, his vital signs were normal, but a palpable posterior..
January 5, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28043849/clavicle-fractures
#13
REVIEW
M Ropars, H Thomazeau, D Huten
Management of clavicle fracture has progressed over the last decade, notably with wider use of surgery in midshaft fracture, and new techniques for lateral fracture. Midshaft clavicle fracture treatment needs to be personalized and adapted to the patient's activity level. Whichever the segment involved, treatment for non-displaced fracture is functional; elbow-to-body sling immobilization seems the best tolerated. Apart from regular surgical indications (shoulder impaction, floating shoulder, open fracture or fracture with neurovascular complications), surgery is recommended in case of bone shortening exceeding 1...
February 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28003076/editorial-commentary-is-posterior-distal-clavicle-beveling-for-chronic-nonincarcerated-type-iv%C3%A2-acromioclavicular-separation-a-sufficient-treatment
#14
EDITORIAL
Jonas Pogorzelski, Peter J Millett
While low-grade acromioclavicular injuries can be managed nonoperatively, high-grade separations may result in persistent pain or functional decline and require surgical intervention. The authors of "Posterior Distal Clavicle Beveling for Chronic Nonincarcerated Type IV Acromioclavicular Separations: Surgical Technique and Early Clinical Outcomes" present a case series reporting convincing results concerning functional outcomes and early return-to-sport rates for this rather rare condition. While this technique seemed to work well in this small series of patients, in our opinion, this procedure should be reserved for use in exceptional cases only...
January 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28003075/editorial-commentary-arthroscopically-assisted-acromioclavicular-joint-reconstruction-not-seeing-does-not-mean-do-not-worry
#15
EDITORIAL
Andreas B Imhoff, Felix Dyrna
To minimize risks during arthroscopic-assisted reduction and internal fixation of acromioclavicular dislocation, drilling should only be performed with an anatomically reduced clavicle. This re-creates the important distances to the neurovascular structures because a posteriorly displaced clavicle reduces the distance to the suprascapular nerve. In addition, visualization is of high importance for the arthroscopic coracoid preparation, as are mini-open incisions, to create an accurate and well-placed tunnel for drilling...
January 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/27994901/avulsion-fracture-of-the-coracoid-process-at-the-coracoclavicular-ligament-insertion-a-report-of-three-cases
#16
Takeshi Morioka, Kiyohisa Ogawa, Masaaki Takahashi
Avulsion fracture at the site of attachment of the coracoid process of the coracoclavicular ligament (CCL) is extremely rare. We presented three adult cases of this unusual avulsion fracture associated with other injuries. Case  1 was a 25-year-old right-handed male with a left distal clavicular fracture with an avulsion fracture of the coracoid attachment of the CCL; this case was treated surgically and achieved an excellent outcome. Case  2 was a 39-year-old right-handed male with dislocation of the left acromioclavicular joint with two avulsion fractures: one at the posteromedial surface of the coracoid process at the attachment of the conoid ligament and one at the inferior surface of the clavicle at the attachment site of the trapezoid ligament; this case was treated conservatively, and unfavorable symptoms such as dull pain at rest and sharp pain during some daily activities remained...
2016: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/27989719/coracoid-bypass-procedure-surgical-technique-for-coracoclavicular-reconstruction-with-coracoid-insufficiency
#17
Mandeep S Virk, Evan Lederman, Christopher Stevens, Anthony A Romeo
BACKGROUND: Failed acromioclavicular (AC) joint reconstruction secondary to a coracoid fracture or insufficiency of the coracoid is an uncommon but challenging clinical situation. We describe a surgical technique of revision coracoclavicular (CC) reconstruction, the coracoid bypass procedure, and report short-term results with this technique in 3 patients. METHODS: In the coracoid bypass procedure, reconstruction of the CC ligaments is performed by passing a tendon graft through a surgically created bone tunnel in the scapular body (inferior to the base of the coracoid) and then fixing the graft around the clavicle or through bone tunnels in the clavicle...
December 15, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27942736/the-doubled-suture-nice-knot
#18
Pascal Boileau, Ghassan Alami, Adam Rumian, Daniel G Schwartz, Christophe Trojani, Adam J Seidl
The authors describe a novel suture fixation technique that combines a doubled suture with a sliding knot. The knot can be tied in both open and arthroscopic surgery to fix torn tendons/ligaments and fractured/osteotomized bones. The advantages of the doubled-suture Nice knot include strength, adjustability, simplicity, and versatility. This technique, which has proven useful in the authors' practice for the past 10 years, has replaced metallic wires and cables for bone fixation. The doubled-suture Nice knot can also be tied over a double-button and has been used for ankle syndesmosis, acromioclavicular joint separation repair, and coracoid bone block fixation...
December 8, 2016: Orthopedics
https://www.readbyqxmd.com/read/27940250/comparative-study-on-the-treatment-of-rockwood-type-iii-acute-acromioclavicular-dislocation-clinical-results-from-the-tightrope-%C3%A2-technique-vs-k-wire-fixation
#19
K Horst, C Garving, T Thometzki, P Lichte, M Knobe, T Dienstknecht, M Hofman, H-C Pape
BACKGROUND AND HYPOTHESIS: The aim of this study was to address the inconsistency regarding the operative treatment of Rockwood type III acromioclavicular joint separation. We compared results after single- and double TightRope(®) reduction with results after acromioclavicular transfixation via K-wires only and additional ligament augmentation in acute acromioclavicular (AC) joint separations graded Rockwood type III, and hypothesized that the TightRope(®) technique leads to better clinical and radiological results...
December 8, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27925640/diagnosis-and-management-of-distal-clavicle-osteolysis
#20
Steven F DeFroda, Christopher Nacca, Gregory R Waryasz, Brett D Owens
Distal clavicle osteolysis is an uncommon condition that most commonly affects weight lifters and other athletes who perform repetitive overhead activity. Although this condition most commonly presents in young active men, it is becoming increasing more common in women with the rise in popularity of body building and extreme athletics. Distal clavicle osteolysis can be debilitating, especially in those with rigorous training regimens, preventing exercise because of pain with activities such as bench presses and chest flies...
December 7, 2016: Orthopedics
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