Operative management of Grade 111 acromioclavicular dislocations in young, active patients is a controversial issue with regard to operative management. Nine patients with complete dislgation (Allman Grade 111) of the acromioclavicular joint who had undergone reconstruction of the coramlavicular ligament with woven Dacron arterial grafts were reviewed clinically. radiologically and functionally utilizing an isokinetic dynamometer. Average follow-up was 2 years and 7 months. All results were good or excellent in terms of function, range of movement and patient acceptance. One patient developed a transient brachial plexus lesion due to compression caused by exuberant heterotopic calcification in the region of the synthetic ligament. One other exceptional patient continued to get more than occasional discomfort. It is concluded that Dacron loop repair is a relatively simple surgical technique with minimal morbidity and high efficacy in restoring stability and function in high demand patients.
Summary
The case of a patient with leptospirosis (treated with trimethoprim) with late neurological complications manifesting as a bilateral plexus syndrome is described. The probable reasons for the continued weakness, in this patient, of the muscles supplied by the anterior interosseus nerve, despite improvement in the proximal muscles, are briefly discussed.
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