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https://www.readbyqxmd.com/read/28097386/biomechanical-analysis-of-clavicle-hook-plate-implantation-with-different-hook-angles-in-the-acromioclavicular-joint
#1
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
#2
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...
December 28, 2016: Injury
https://www.readbyqxmd.com/read/28054147/prevalence-of-remaining-horizontal-instability-in-high-grade-acromioclavicular-joint-injuries-surgically-managed
#3
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
#4
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
#5
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...
December 30, 2016: 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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/27900310/rockwood-grade-i-and-ii-acromioclavicular-injuries-as-benign-as-commonly-believed
#13
Alexander Scott North
The acromioclavicular (AC) joint is the articulation between the distal clavicle and the acromion process of the scapula. As the upper limb moves, passive motion of the AC joint occurs in three planes, with the AC and coracoclavicular ligaments providing stability. Injuries are common, particularly during contact sports, and are classified using Rockwood's system. Grade I (sprain) and II (rupture) injuries only affect the AC ligaments and are generally managed conservatively. However, recent reports have indicated that long-term outcomes after these injuries are poor, perhaps due to an inadequate period of immobilization preventing complete ligamentous healing...
July 2016: Joints
https://www.readbyqxmd.com/read/27866794/treatment-of-symptomatic-acromioclavicular-joint-instability-by-a-docking-technique-clinical-indications-surgical-technique-and-outcomes
#14
W Ben Kibler, Aaron D Sciascia, Brent J Morris, David C Dome
PURPOSE: To report functional and objective outcomes resulting from surgical treatment of patients with symptomatic type III through V acromioclavicular (AC) joint injury by use of a modification of the anatomic AC joint reconstruction developed by Carofino and Mazzocca. METHODS: The study included all patients treated in 2009-2014 who presented with a history of direct trauma to the shoulder; deformity of the AC joint on clinical examination; radiographic findings that would classify the injury as a Rockwood type III, IV, or V injury; AC joint instability on clinical examination; and self-reported deficits of arm function on initial presentation, in whom a comprehensive and directed nonoperative program failed...
November 17, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/27855670/influence-of-disruption-of-the-acromioclavicular-and-coracoclavicular-ligaments-on-glenohumeral-motion-a-kinematic-evaluation
#15
Kempland C Walley, Babak Haghpanah, Andreas Hingsammer, Ethan R Harlow, Ashkan Vaziri, Joseph P DeAngelis, Ara Nazarian, Arun J Ramappa
BACKGROUND: Changes to the integrity of the acromioclavicular (AC) joint impact scapulothoracic and clavicular kinematics. AC ligaments provide anterior-posterior stability, while the coracoclavicular (CC) ligaments provide superior-inferior stability and a restraint to scapular internal rotation. The purpose of this cadaveric study was to describe the effect of sequential AC and CC sectioning on glenohumeral (GH) kinematics during abduction (ABD) of the arm. We hypothesized that complete AC ligament insult would result in altered GH translation in the anterior-posterior plane during abduction, while subsequent sectioning of both CC ligaments would result in an increasing inferior shift in GH translation...
November 17, 2016: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/27821995/unstable-acromioclavicular-joint-injuries-is-there-really-a-difference-between-surgical-management-in-the-acute-or-chronic-setting
#16
Luis Natera Cisneros, Juan Sarasquete Reiriz
AIM: To compare the outcomes of unstable ACJ injuries managed with an arthroscopy-assisted anatomic reconstruction of the coracoclavicular (CC) ligaments in the acute and chronic setting. METHODS: A retrospective revision was performed. The SF36, visual analog scale for pain, DASH questionnaire, constant score and the global satisfaction were assessed at the last follow-up visit. RESULTS: 22 patients were included. Results of the questionnaires assessed at the last follow-up visit showed no significant differences between the study groups...
March 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/27818978/functional-and-radiological-evaluation-of-acute-acromioclavicular-dislocation-treated-with-anchors-without-eyelet-comparison-with-other-techniques
#17
Alexandre Tadeu do Nascimento, Gustavo Kogake Claudio
OBJECTIVE: To assess the repair results of acromioclavicular dislocations (ACJD) grades III and V, with anchors without eyelet, when compared with other techniques, and to evaluate factors that can affect the final result. METHODS: A retrospective study of 36 patients with ACJD grades III and V in the Rockwood classification, 12 treated with anchors without eyelet, 11 with one tightrope, six with two tightropes, and six with subcoracoid cerclage, operated from September 2012 to February 2015...
September 2016: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/27818896/midterm-results-of-coracoclavicular-stabilization-with-double-augmentation-for-acute-acromioclavicular-dislocation
#18
Sungwook Choi, Tong-Joo Lee, Myung-Ku Kim, Ji Eun Park, Hyunseong Kang
INTRODUCTION: Numerous techniques have been introduced for the treatment of acute acromioclavicular (AC) joint dislocation. We aim to report the midterm results of coracoclavicular (CC) stabilization with double augmentation for the acute AC joint dislocation. CASE DESCRIPTION: Forty-three patients who underwent surgery for acute AC joint dislocation were followed up for an average of 59.6 months (range 40-97). The study composed of two treatment groups: group S, with 25 patients, in whom two suture anchors were used; and group B, with 18 patients, in whom a suture anchor and a double flip-button device were used, however the techniques in both groups are based on the same principle which is double augmentation...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27776006/arthroscopic-assisted-acromioclavicular-and-coracoclavicular-ligaments-reconstruction-for-chronic-acromioclavicular-dislocations-surgical-technique
#19
Achilleas Boutsiadis, Laurent Baverel, Hubert Lenoir, Philippe Delsol, Johannes Barth
Chronic acromioclavicular (AC) instability is a rare posttraumatic shoulder condition that can lead to undesirable symptoms like persistent pain, muscle fatigue, loss of strength, or even scapular dyskinesis. It is well known that in these cases the superior functional results depend on the restoration of the anatomy and stability of the AC joint in both vertical and horizontal planes. Considering the ligaments degeneration and atrophy in chronic AC joint dislocations, we present an arthroscopic-assisted reconstruction of both the coracoclavicular and AC ligaments using autograft augmentation...
December 2016: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/27765500/loss-of-reduction-and-complications-of-coracoclavicular-ligament-reconstruction-with-autogenous-tendon-graft-in-acute-acromioclavicular-dislocations
#20
Nam Hong Choi, Seok Min Lim, Sang Young Lee, Tae Kang Lim
BACKGROUND: This study was conducted to report loss of reduction and complications after single-tunnel coracoclavicular (CC) ligament reconstruction with autogenous semitendinosus tendon graft for acute acromioclavicular (AC) joint dislocations. METHODS: This retrospective study included patients with acute, unstable AC dislocations (surgery within 6 weeks after trauma). We excluded patients with chronic injury and distal clavicle fractures with CC ligaments disruption...
October 17, 2016: Journal of Shoulder and Elbow Surgery
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