scholarly journals Treatment of acute high-grade acromioclavicular joint dislocation

2020 ◽  
Vol 23 (3) ◽  
pp. 159-165
Author(s):  
Jeung Yeol Jeong ◽  
Yong-Min Chun
Keyword(s):  
Standard Procedure ◽  
High Energy ◽  
Acromioclavicular Joint Dislocation ◽  
High Grade ◽  
Shoulder Injuries ◽  
Ac Joint ◽  
Joint Injury ◽  
Joint Dislocation ◽  
Treatment Type ◽  
Joint Dislocations

Acromioclavicular (AC) joint dislocations account for about 9% of shoulder injuries. Among them, acute high-grade injury following high-energy trauma accounts for a large proportion of patients requiring surgical treatment. However, there is no gold standard procedure for operative treatment of acute high-grade AC joint injury, and several different procedures have been used for this purpose in clinical practice. This review article summarizes the most recent and relevant surgical options for acute high-grade AC joint dislocation patients and the outcomes of each treatment type.

scholarly journals Ipsilateral midshaft clavicle fracture and acromioclavicular joint dislocation: a review of literature and evidence-based diagnosis guidelines

2020 ◽  
Author(s):  
Rongguang Ao ◽  
Zhen Jian ◽  
Jinhong Chen ◽  
Dejian Li ◽  
Xu Zhang ◽  
...  
Keyword(s):  
Clavicle Fracture ◽  
High Energy ◽  
Shoulder Function ◽  
Acromioclavicular Joint Dislocation ◽  
Evidence Based ◽  
Ac Joint ◽  
Level Of Evidence ◽  
Joint Dislocation ◽  
Type Iv ◽  
Ac Joint Dislocation

Abstract Background: Ipsilateral midshaft clavicle fracture and AC joint dislocation are rare, with very few cases reported. Once the AC joint dislocation were missed diagnosis, the shoulder function may be affected and medical dispute was easy to occur. The aim of this study was to gather data relating to ipsilateral midshaft clavicle fracture and AC joint dislocation to develop evidence-based diagnosis guidelines as none are currently available.Methods: A study was conducted of the PubMed and Google Scholar databases to identify cases of ipsilateral midshaft clavicle fracture and AC joint dislocation. Data collected about each case included age and gender of the patient, mechanism of injury, fracture and dislocation classification. The authors report 2 additional ipsilateral midshaft clavicle fracture and AC joint dislocation cases.Results: 21 cases were identified for inclusion in this research, 19 from the literature and 2 reported by the authors. All the patients were injured by high energy trauma. For the midshaft fracture, 16/21 (76.2%) patients belonged to Type A classification, and 5/21 (23.8%) patients belonged to Type B classification. For AC joint dislocation, 11/21 (47.6%) patients belonged to Type IV classification, 4/21 (19.0%) patients belonged to Type VI classification, 5/21 (23.8%) patients belonged to Type III classification and 1/21 (4.7%) patients belonged to Type V classification.Conclusions: There are limited data available about the diagnosis of ipsilateral midshaft clavicle fracture and AC joint dislocation. From the cases reviewed, we find that simple midshaft clavicle caused by high energy injuries may be associated with ipsilateral AC joint dislocation. Physical examination, careful observation of preoperative X-ray and fluoroscopy including the AC joint during operation were key to diagnose the injury. Level of Evidence Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

scholarly journals Clavicle Elevation or Shoulder Girdle Depression in Acromioclavicular Joint Dislocation: A Radiological Investigation

2019 ◽  
Vol 7 (11) ◽  
pp. 232596711987992 ◽  
Author(s):  
Fady Azar ◽  
Christian Pfeifer ◽  
Volker Alt ◽  
Benedikt Pregler ◽  
Isabella Weiss ◽  
...  
Keyword(s):  
Spinal Column ◽  
Shoulder Girdle ◽  
Classification Systems ◽  
Acromioclavicular Joint Dislocation ◽  
Ac Joint ◽  
Level Of Evidence ◽  
Radiological Investigation ◽  
Cross Sectional ◽  
Joint Injury ◽  
Joint Dislocations

Background: The side-comparative coracoclavicular (CC) distance is used to describe the vertical instability component of acute acromioclavicular (AC) joint dislocations. Elevation of the clavicle or a depression of the shoulder girdle can lead to an increased CC distance. The dislocation direction has not yet been investigated and is not included in common classification systems. Hypothesis: Clavicle elevation is primarily responsible for vertical dislocation in AC joint separation. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Weighted and nonweighted bilateral plain anteroposterior views of the shoulder girdles of patients with AC joint dislocations (Rockwood [RW] types III and V), diagnosed in our trauma department between 2001 and 2018, were included in this study. After determining the CC distance, a side-comparative determination of the positions of both the clavicle and shoulder girdle, with reference to the spinal column, was conducted. Results: In total, 245 bilateral plain anteroposterior views were evaluated (RW III, n = 116; RW V, n = 129). All patients showed a side-comparative clavicle elevation (mean ± SD: RW III, 5 ± 14 mm; RW V, 11 ± 17 mm) in weighted and nonweighted views. While no depression of the shoulder girdle was measured in RW III injuries (weighted and nonweighted views, 0 ± 11 mm), dropping of the shoulder girdle in RW V lesions on nonweighted views was observed (–5 ± 11 mm). Conclusion: Vertical dislocation is mostly associated with clavicle elevation in RW III injures, while in high-grade AC joint dislocations (RW V), a combination of clavicle elevation and shoulder girdle depression is present. A significantly greater superior displacement of the clavicle in RW V injuries was seen in weighted views, while a depression of the shoulder girdle could be detected in nonweighted views. For the first time, these results include the dislocation direction in the classification of an AC joint injury. Further studies are needed to investigate the extent to which dislocation types differ in optimal therapy and outcome.

scholarly journals Outcome of Acromio-Clavicular joint dislocation operated using clavicle hook plate

2018 ◽  
Vol 8 (2) ◽  
pp. 41-43
Author(s):  
Akesh Prajapati ◽  
Jyoti Sitaula ◽  
Bishnu Dev Sharma ◽  
Sujit Shrestha ◽  
Pujan Pant ◽  
...  
Keyword(s):  
Los Angeles ◽  
Excellent Result ◽  
Hook Plate ◽  
Acromioclavicular Joint Dislocation ◽  
Ac Joint ◽  
Rockwood Classification ◽  
Joint Dislocation ◽  
Joint Dislocations ◽  
Rockwood Type Iii ◽  
Clavicle Hook Plate

Rockwood classification of AC joint dislocation is generally accepted worldwide. Treatment of Rockwood Type 1 and 2 AC joint is non-operative while all authors advocate operative treatment for Rockwood Type 4 and 5 AC joint dislocations. Thirty consecutive patients who underwent operation for acromioclavicular joint dislocation using clavicle hook plate from June 2015 were studied. The dislocations ranged from Rockwood type III to type V. Average follow up time was fourteen months ranging from four to twenty-four months. The outcome was measured using University of California Los Angeles (UCLA) shoulder score. All-the patient had good to excellent result.

scholarly journals Acute high-grade acromioclavicular joint dislocation patients treated with titanium cable insertion under a homemade guider

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Jun Wang ◽  
Yongfeng Cui ◽  
Yuhang Zhang ◽  
Hang Yin
Keyword(s):  
Acromioclavicular Joint ◽  
Double Bundle ◽  
Acromioclavicular Joint Dislocation ◽  
High Grade ◽  
Ac Joint ◽  
Joint Dislocation ◽  
X Ray ◽  
Radiographic Outcomes ◽  
Ac Joint Dislocation ◽  
Coracoclavicular Distance

Abstract Backgrounds To describe a new technique for implanting a double-bundle titanium cable to treat acromioclavicular (AC) joint dislocation via the new guider, and evaluate clinic outcomes. Methods A retrospective study of patients treated for acute high-grade acromioclavicular joint dislocation from June 2016 to January 2020 in our trauma center, twenty patients with AC joint dislocation were managed with double-bundle titanium cable. It includes the following steps: (1) Put the guider under the coracoid close to the cortical; (2) drill proximal clavicle; (3) place the titanium cable; (4) perforate distal clavicle, (5) reset the acromioclavicular joint and lock titanium cable; and (6) suture the acromioclavicular ligament. An independent reviewer conducted functional testing of these patients, including the use of coracoclavicular distance (CCD), visual analog scale (VAS) scores, and Constant–Murley scores (CMS). Results All patients are presented following at a median duration of 15 months (12-24months) after the surgery. All patients based on X-ray evaluation and clinic evaluation. The median CCD was 7.5 (6–14) mm, the VAS score was 0.55 (0-2), the CMS score was 95.5 (92-99). One patient had subluxation again at the final follow-up based on X-ray examination. Conclusions This study demonstrates that the AC joint fixation anatomically with double-bundle titanium, acquired excellent outcomes in terms of the recovery of shoulder joint function and radiographic outcomes. It has a low complication rate and need not remove the hardware.

Factors Predicting the Outcome After Arthroscopically Assisted Stabilization of Acute High-Grade Acromioclavicular Joint Dislocations

2019 ◽  
Vol 47 (11) ◽  
pp. 2670-2677 ◽  
Author(s):  
Nina Maziak ◽  
Laurent Audige ◽  
Carmen Hann ◽  
Marvin Minkus ◽  
Markus Scheibel
Keyword(s):  
Clinical Outcome ◽  
Acromioclavicular Joint ◽  
High Grade ◽  
Radiological Outcome ◽  
Ac Joint ◽  
Level Of Evidence ◽  
Outcome Parameters ◽  
Joint Dislocations ◽  
Anatomic Reduction ◽  
Arthroscopically Assisted

Background: Factors influencing the outcome after arthroscopically assisted stabilization of acute high-grade acromioclavicular (AC) joint dislocations remain poorly investigated. Purpose: To identify determinants of the radiological outcome and investigate associations between radiological and clinical outcome parameters. Study Design: Cohort study; Level of evidence, 3. Methods: The authors performed a retrospective analysis of patients who underwent arthroscopically assisted stabilization for acute high-grade AC joint dislocations. The following potential determinants of the radiological outcome were examined using univariable and multivariable regression analyses: timing of surgery, initial AC joint reduction, isolated coracoclavicular (CC) versus combined CC and AC stabilization, ossification of the CC ligaments, age, and overweight status. In addition, associations between radiological (ie, CC difference, dynamic posterior translation [DPT]) and clinical outcome parameters (Subjective Shoulder Value, Taft score [TS] subjective subcategory, and Acromioclavicular Joint Instability Score [ACJI] pain subitem) were evaluated using univariable analysis. Results: One hundred four patients with a mean (±SD) age of 38.1 ± 11.5 years were included in this study. The mean postoperative follow-up was 2.2 ± 0.9 years. Compared with patients with an overreduced AC joint after surgery, the CC difference was 4.3 mm (95% CI, 1.3-7.3; P = .006) higher in patients with incomplete reduction. Patients with anatomic reduction were 3.1 times (95% CI, 1.2-7.9; P = .017) more likely to develop DPT than those with an overreduced AC joint. An incompletely reduced AC joint was 5.3 times (95% CI, 2.1-13.4; P < .001) more likely to develop DPT versus an overreduced AC joint. Patients who underwent isolated CC stabilization were 4.8 times (95% CI, 1.1-21.0; P = .039) more likely to develop complete DPT than patients with additional AC stabilization. Significantly higher CC difference values were noted for patients who reported pain on the subjective TS ( P = .025). Pain was encountered more commonly in patients with DPT ( PTS = .049; PACJI = .038). Conclusion: Clinicians should consider overreduction of the AC joint because it may lead to favorable radiological results. Because of its association with superior radiographic outcomes, consideration should also be given to the use of additional AC cerclage.

scholarly journals Treatment of chronic acromioclavicular joint dislocation in a paraplegic patient with the Weaver-Dunn procedure and a hook-plate

2016 ◽  
Vol 8 (2) ◽  
Author(s):  
Holger Godry ◽  
Mustafa Citak ◽  
Matthias Königshausen ◽  
Thomas A. Schildhauer ◽  
Dominik Seybold
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Weight Bearing ◽  
Full Range ◽  
Hook Plate ◽  
Acromioclavicular Joint Dislocation ◽  
Ac Joint ◽  
Joint Dislocation ◽  
Ac Joint Dislocation ◽  
Cord Injury

Abstract In case of patients with spinal cord injury and concomitant acromioclavicular (AC) jointdislocation the treatment is challenging, as in this special patient group the function of the shoulder joint is critical because patients depend on the upper limb for mobilization and wheelchair-locomotion. Therefore the goal of this study was to examine, if the treatment of chronic AC-joint dislocation using the Weaver- Dunn procedure augmented with a hook-plate in patients with a spinal cord injury makes early postoperative wheelchair mobilization and the wheelchair transfer with full weightbearing possible. In this case the Weaver- Dunn procedure with an additive hook-plate was performed in a 34-year-old male patient with a complete paraplegia and a posttraumatic chronic AC-joint dislocation. The patient was allowed to perform his wheelchair transfers with full weight bearing on the first postoperative day. The removal of the hook-plate was performed four months after implantation. At the time of follow-up the patient could use his operated shoulder with full range of motion without restrictions in his activities of daily living or his wheel-chair transfers.

scholarly journals Clinical and Radiological Results of Hook Plate Fixation in Acute Acromioclavicular Joint Dislocations and Distal Clavicle Fractures

2018 ◽  
Vol 21 (2) ◽  
pp. 95-100
Author(s):  
Joo Han Oh ◽  
Seunggi Min ◽  
Jae Wook Jung ◽  
Hee June Kim ◽  
Jae Yoon Kim ◽  
...  
Keyword(s):  
Plate Fixation ◽  
Clavicle Fracture ◽  
Hook Plate ◽  
Distal Clavicle ◽  
Ac Joint ◽  
Joint Dislocation ◽  
Group I ◽  
Joint Dislocations ◽  
Ac Joint Dislocation ◽  
Group Ii

BACKGROUND: The purpose of this study was to evaluate the clinical outcomes and complications of hook plate fixation in acromioclavicular (AC) joint dislocations and distal clavicle fractures.METHODS: We retrospectively reviewed a series of 60 consecutive patients with hook plate fixation for AC joint dislocation (group I) and distal clavicle fracture (group II). Groups I and II had 39 and 21 patients, respectively. Clinical results were evaluated using the pain visual analogue scale (VAS), simple shoulder test, and Constant-Murley scores. In addition, subacromial erosion and stiffness were evaluated as complications.RESULTS: At the removal, the pain VAS was 2.69 ± 1.30 and 4.10 ± 2.14 in groups I and II, respectively, which were significantly different (p=0.003). The simple shoulder test score was 9.59 ± 1.60 and 7.81 ± 2.67 in groups I and II, respectively, which were also significantly different (p=0.002). Subacromial erosion was significantly more frequent in group II (14/21 patients, 66.7%) than in group I (15/39 patients, 38.5%) (p=0.037), and stiffness was also higher in group II (17/21 patients, 81.0%) than in group I (22/39 patients, 56.4%), but it was not significant.CONCLUSIONS: Hook plate fixation showed good clinical and functional results for the treatment of acute unstable AC joint dislocation and distal clavicle fracture. But, in distal clavicle fractures, there are more subacromial erosion and stiffness compare with acute unstable AC joint dislocation.

Acromion Fracture and Acromioclavicular Joint Dislocation: A Case Report

2020 ◽  
Author(s):  
Mohammad Zarei ◽  
Saied Besharaty ◽  
Alireza Moharrami ◽  
Rasul Ghaedi
Keyword(s):  
Acromioclavicular Joint Dislocation ◽  
Early Recovery ◽  
Ac Joint ◽  
Early Management ◽  
Case Presentation ◽  
Joint Dislocation ◽  
Ac Joint Dislocation ◽  
Acromion Fracture ◽  
Acromial Fracture ◽  
Clavicle Fractures

Background: Acromion fractures are rare injuries that may occur because of shoulder trauma. This may be associated with distal clavicle fractures, which can be an indication for surgery. There are several methods, which are used for fixation of this type of fractures. Case Presentation: In this paper, we presented a 34 years old man with acromion fracture in contribution with acromioclavicular (AC) joint dislocation. We applied a new method for fixation of this fracture. The fracture was fixed by 2 screws and AC Joint was fixed by a 4-hole hook plate. Conclusions: It is important to be aware of acromial fracture to not miss them and also for early management, so that early recovery and satisfactory results can be gained

The Function of the Acromioclavicular and Coracoclavicular Ligaments in Shoulder Motion

2012 ◽  
Vol 40 (11) ◽  
pp. 2617-2626 ◽  
Author(s):  
Satoshi Oki ◽  
Noboru Matsumura ◽  
Wataru Iwamoto ◽  
Hiroyasu Ikegami ◽  
Yoshimori Kiriyama ◽  
...  
Keyword(s):  
Horizontal Plane ◽  
Acromioclavicular Joint ◽  
Sagittal Plane ◽  
Shoulder Girdle ◽  
Surgical Reconstruction ◽  
Acromioclavicular Joint Dislocation ◽  
Joint Dislocation ◽  
3 Dimensional ◽  
Joint Dislocations ◽  
Ligament Disruption

Background: Scapulothoracic dyskinesis is an important consequence of acromioclavicular joint dislocations. However, no reports have described changes in 3-dimensional motions of the scapula and clavicle with respect to the thorax caused by acromioclavicular joint dislocation. Hypothesis: Sectioning of the acromioclavicular (AC) and coracoclavicular (CC) ligaments affects scapular and clavicular motion in a whole-cadaver model. Study Design: Controlled laboratory study. Methods: We evaluated shoulder girdle motion (scapula, clavicle, and humerus) relative to the thorax of 14 shoulders from 8 whole cadavers after sequential sectioning of the AC and CC ligaments (trapezoid and conoid ligaments). An electromagnetic tracking device measured 3-dimensional kinematics of the scapula and clavicle during humerothoracic elevation in the coronal and sagittal planes and adduction in the horizontal plane. Results: Sectioning of the AC ligament increased clavicular retraction during sagittal plane elevation and horizontal plane adduction. Sectioning of the trapezoid ligament decreased scapular external rotation during sagittal plane elevation and horizontal plane adduction. Sectioning of the conoid ligament decreased scapular posterior tilting during sagittal plane elevation and horizontal plane adduction. Acromioclavicular and CC ligament sectioning also delayed clavicular posterior rotation and increased clavicular upward rotation during coronal plane elevation. Conclusion: Our study revealed that AC and CC ligament disruption affected in vitro shoulder girdle kinematics in the whole-cadaver model. Clinical Relevance: The results of this cadaveric study revealed that AC and CC ligament disruption could cause dyskinesis of the scapula and clavicle. The kinematic changes could be a potential source of pain and dysfunction in the shoulder with AC joint dislocation, and therefore surgical reconstruction may be indicated in certain patients.

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