Acromioclavicular joint injuries: indications for treatment and treatment options

Johansen, John A.; Grutter, Paul W.; McFarland, Edward G.; Petersen, Steve A.

doi:10.1016/j.jse.2010.10.030

Cited by 96 publications

(99 citation statements)

References 82 publications

(131 reference statements)

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“…Despite the advantage of technical simplicity, acromioclavicular fixation by means of metal wires may present the complications of migration of the wires, infection, arthrosis and loss of reduction (24,25) . There are several techniques for fixation of the clavicle to the coracoid process (9) . Bosworth screws present the disadvantage of requiring a new procedure to remove them, and they present high rates of osteolysis in the clavicle (9) .…”

Section: Discussionmentioning

confidence: 99%

“…There are several techniques for fixation of the clavicle to the coracoid process (9) . Bosworth screws present the disadvantage of requiring a new procedure to remove them, and they present high rates of osteolysis in the clavicle (9) . High-resistance threads that are tied off in the subcoracoid area may cause local bone erosion and maintain the anterior subluxation of the clavicle, and this has been shown to cause pain, arthritis and diminished strength (26) .…”

Section: Discussionmentioning

confidence: 99%

“…2012;47(5):563-7 while types IV, V and VI require surgical treatment (8) . More than 75 techniques have been described for surgically treating acromioclavicular dislocation, but none of them has been established as the gold standard (9) . The techniques include fixation of the acromioclavicular joint using wires or a plate (10,11) , transfer of the coracoacromial ligament (12) , fixation of the coracoacromial interval using a screw, suturing anchors or lashing with suturing wires (13,14) and reconstruction of the coracoclavicular and acromioclavicular ligaments (15) .…”

Section: Introductionmentioning

confidence: 99%

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Via de acesso cirúrgico posterossuperior para o tratamento das luxações acromioclaviculares: resultados de 84 casos operados

et al. 2012

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Objective: To evaluate the results from surgical treatment of 84 cases of acute acromioclavicular dislocation, using a posterosuperior access route. Methods: Eighty-four cases of acute acromioclavicular dislocation (grade III in the Allman-Tossy classification) operated between November 2002 and May 2010 were evaluated. The patients' mean age was 34 years. The diagnoses were made using clinical and radiographic evaluations. The patients were operated by the same surgical team, within three weeks of the date of the trauma, using a posterosuperior approach to the shoulder to access the top of the base of the coracoid process for placement of two anchors, which were used in reducing the dislocation. The minimum follow-up was 12 months. The postoperative clinicalradiographic evaluation was done using the modified Karlsson criteria and the University of California at Los Angeles (UCLA) score. Results: 92.8% of the 84 patients treated presented good or excellent results, and 7.2% presented fair or poor results, using the UCLA assessment score. According to the modified Karlsson criteria, 76.2% were assessed as grade A, 17.9% as grade B and 5.9% as grade C. Conclusion: The posterosuperior access route to the shoulder is a new option for accessing the coracoid process and treating acromioclavicular dislocation, with clinical and radiographic results equivalent to those in the literature.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Via de acesso cirúrgico posterossuperior para o tratamento das luxações acromioclaviculares: resultados de 84 casos operados

et al. 2012

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“…When Rockwood expanded the three-part classifications of Allman [1] and Tossy et al [32], it was accepted among surgeons that Types I and II were treated nonoperatively, that Types IV, V, and VI might best be treated by surgery, and that management of Type III injuries was controversial. This consensus holds today [4,5,13,18,21,28,31], and the controversy regarding treatment of Type III persists. Historically, studies have shown good clinical results with nonoperative treatment of Type III injuries [4,7,17,23,30], whereas others have shown greater success with surgical treatment [11,14].…”

Section: Limitationsmentioning

confidence: 99%

“…Various surgical techniques, anatomic and nonanatomic, and recommendations regarding timing of surgical intervention have been described, but no consensus on optimal treatment exists [5,13]. Treatment for Type III injuries also must be individualized based on factors like the patient's activity level, functional impairment, occupational demands, type of sport, level of play, and the patient's aesthetic preferences regarding the injured shoulder.…”

Section: Limitationsmentioning

confidence: 99%