THESIS ON ACROMIOCLAVICULAR JOINT
Patients are discharged on the second postoperative day after a wound dressing. Effect of capsular injury on acromioclavicular joint mechanics. An indirect suture shuttle usually Ethilon 1 is passed under the coracoid with the help of a Satinsky forceps from medial to lateral. There have been reports of high failure of mechanical devices [ 20 ]. Functional in overhead athletes.
The modern approach has been to reconstruct anatomic CC ligament with fixation or a loop at base of coracoid and a biological graft passing through clavicle either through a single drill hole or 2, to mimic the course of the conoid and trapezoid ligament. Eaton R, Serletti J. Stam L, Dawson I. This article does not contain any studies with human or animal subjects performed by the authors. The anterior-posterior displacement of AC joint also tends to cause more symptoms, which may be unaddressed, by merely restoring the superior inferior stability with CC ligament reconstruction. This procedure was initially described in , utilized the Coraco-Acromial CA ligament to substitute the torn CC ligament; this procedure involved the release of the Coraco-Acromial ligament from the acromion, resection of the distal end of the clavicle, and transfer of the CA ligament to the lateral end of the clavicle, more closely replicating the CC ligaments. Most patients do not require a formal rehabilitation program.
Repair of complete acromioclavicular separations using the acromioclavicular-hook plate.
The CC ligament is one of the strongest ligaments in the body. Migration of a threaded Steinmann pin from an acromioclavicular joint into the spinal canal: Under general anesthesia, with the patient in a beach chair position, the shoulder and arm is draped free.
Cosmetic deformity is only one of the aspects of this condition.
Acromioclavicular joint dislocations
The technique remains the same, while the challenge is to loop the graft around the coracoid base. This review of AC joint dislocations intends to analyze the tyesis surgical options, a critical analysis of existing literature, actual technique of anatomic repair, and also accompanying complications.
Thesie sign may be elicited with ballottement of the lateral end of clavicle. Even among surgeons acromioclsvicular to operate AC joint dislocations there is no unanimity on acrimioclavicular surgical technique. Most common is type III. When the clavicle drill hole is made lateral to the coracoid, the 2 strands of the graft chart a different vector, with each strand charting different course—mimicking the conoid and trapezoid path.
An implant for fixation without addressing the CC ligament is likely to fail. There have been athletes from national teams who have happily carried out with their activity. The parent CC ligament is inserted at the very base of the coracoid — whereas the CA ligament is attached much to distally and laterally.
A biomechanical evaluation of an anatomical coracoclavicular ligament reconstruction. A significant number of patients have been treated conservatively for type III dislocations and hence, the recommendations for treating type III AC joint are controversial.
Acromioclavicular joint dislocations
The anatomic coracoclavicular ligament reconstruction: The posterior and superior ligaments are the strongest and are invested by the deltotrapezial jiont. Disorders of the acromioclavicular joint. This application has been extended to AC joint dislocations.
Involves the use of various types of materials, for example, heavy suture or surgical tape, allograft, or autograft, which are placed around the base of the coracoid and through the distal end of the clavicle and fixed in place with various fixation means, such as suture anchors, suture buttons, and interference screws. We are describing here the anatomic technique of reconstructing the CC ligaments with the semitendinoses graft as described by the senior author.
K-wire and Steinman pin migrations can create more injury and also embarrassing evidence on postoperative radiographs [ 31 — 37 ]. The most common complaint in the late setting is a nagging medial scapular pain. This article has been cited by other articles in PMC.
They reported that the graft sutured on to itself with supplemental sutures was the most secure method of fixation. However, it may be difficult to delineate aggravation of old thhesis and new injuries.
Hook plate The Hook Plate was originally designed for lateral end clavicle fractures. Repair of acromioclavicular separations with knitted Thessi graft. Treatment of acromioclavicular joint separation: The periosteal of the coracoid is abraded with a rasp on both sides to allow the donor graft to integrate with the coracoid.
The force initially injures the acromioclavicular ligaments. Evaluation and treatment of acromioclavicular joint injuries. On the other hand it is possible that a young patient continues to be symptomatic even after a substantial conservative trial.
Strapping is restrictive and often nonproductive and a variety of techniques, from K-wire fixation to synthetic grafts have led to lack of confidence in choosing the correct treatment. Biomechanical studies have shown that the AC ligaments and capsule are important in providing anterior-posterior stability to the AC joint.