Coracoclavicular Wiring for Acromioclavicular Joint Dislocation:<i>A Ten Year Follow-up Study</i>

Ejeskär, Arvid

doi:10.3109/17453677408989674

Cited by 18 publications

(8 citation statements)

References 9 publications

(1 reference statement)

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“…Dabei traten solche Veränderungen häufiger nach operativer Versorgung der AC-Gelenksprengung auf als nach konservativer Therapie [14,22,23,25,27,29,30,36,38,42]. Dabei traten solche Veränderungen häufiger nach operativer Versorgung der AC-Gelenksprengung auf als nach konservativer Therapie [14,22,23,25,27,29,30,36,38,42].…”

Section: Introductionunclassified

Vergleich und Ergebnis von Schultereckgelenkverletzungen II. und III. Grades

Reichkendler

Rangger

Dessl³

et al. 1996

Der Unfallchirurg

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Eighty-five patients with grade 2 or grade 3 sprains of the acromioclavicular (AC) joint were evaluated clinically and radiographically 32 months after injury. Group I included 34 patients with grade 2 sprains (Tossy II) and group II included 51 patients with grade 3 injuries (Tossy III). In group I, 15 patients were treated surgically (group Ia) and 19 patients were treated conservatively (group Ib), while in group II, 41 patients were treated surgically (group IIa) and 10 patients were treated conservatively (group IIb). At surgery open reduction and transarticular fixation of the AC joint with Kirschner wires was performed. Conservative treatment included the initial use of a sling or a knapsack bandage and early performance of range-of-motion exercises. Shoulder function was assessed according to the score devised by Constant and Murley. In both groups, 97 of 100 possible points (minimum 72, maximum 100) were obtained after conservative and after surgical treatment. Nine of 10 patients (90%) with grade 3 sprains (group IIb) had more pronounced displacement and increased mobility of the lateral end of the clavicle after conservative treatment. After surgery, dislocation and increased horizontal, mobility of the lateral end of the clavicle occurred in 18 (44%) of 41 patients with grade 3 sprains (group IIa P < 0.0001). However, these findings did not correlate with the functional outcome. At follow-up there was a significant increase in degenerative changes seen on radiographs (P < 0.035) in all patients. Again these findings did not correlate with the functional outcome. More degenerative radiological changes were observed in patients who had undergone surgery (P < 0.003). Patients with grade 2 sprains were more frequently restricted in sporting activity after surgery (P < 0.05). Patients with grade 3 sprains who were treated surgically complained of pain more frequently (P < 0.01), and they returned to work later than patients who were treated conservatively after grade 3 sprains. An additional rehabilitation program guided by a physiotherapist seemed to have no impact on the functional outcome. A total of 56 patients were treated by surgery. Among these patients 11 complications occurred, requiring five additional surgical procedures. Among 29 conservatively treated patients, only in 1 patient did subacromially located arthritic changes of the AC joint have to be removed.

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Section: Introductionunclassified

Vergleich und Ergebnis von Schultereckgelenkverletzungen II. und III. Grades

Reichkendler

Rangger

Dessl³

et al. 1996

Der Unfallchirurg

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“…Of these, 191 were excluded based on their abstract and 47 additional studies were excluded based on the full‐text article. One hundred and thirty‐three [1, 2, 4, 5, 7–10, 12–15, 17–23, 25, 29, 30, 32–41, 43–46, 49–52, 54–61, 64–67, 69–73, 75–82, 86–95, 97–99, 102–109, 111, 113, 117, 118, 120, 122–130, 133, 135, 137–139, 143, 144, 146–156, 158, 160–162, …”

Section: Resultsmentioning

confidence: 99%

“…Loss of reduction was reported on X‐rays in 116 studies [2, 4, 7, 10, 12–15, 17–23, 25, 29, 30, 32–41, 43, 45, 46, 49–52, 54–61, 64–67, 69–73, 75–77, 86–88, 90–92, 94, 95, 97, 98, 102–104, 106–109, 111, 117, 118, 122–130, 133, 135, 137–139, 143, 144, 146–154, 156, 158, 160–162, 165–167, 170–177], computed tomography (CT) was used in one study...…”

Section: Resultsmentioning

confidence: 99%

Biologic and synthetic ligament reconstructions achieve better functional scores compared to osteosynthesis in the treatment of acute acromioclavicular joint dislocation

Saccomanno

Sircana

Cardona

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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Purpose To systematically review the outcomes of surgical treatments of acute acromioclavicular joint dislocation. Methods Studies were identified by electronic databases (Ovid, PubMed). All studies reporting functional and radiological outcomes of surgical treatments of acute acromioclavicular joint dislocations were included. Following data were extracted: authors and year, study design, level of evidence, number of patients, age, classification of acromioclavicular joint dislocation, time to surgery, surgical technique, follow-up, clinical and imaging outcomes, complications, and failures. Descriptive statistics was used, when a data pooling was not possible. Comparable outcomes were pooled to generate summary outcomes reported as frequency-weighted values. Quality appraisal was assessed through the MINORS checklist. Results One hundred and thirty-three studies were included for a total of 4473 shoulders. Mean age of participants was 36.9 years. Mean follow-up was 42.06 months. Arthroscopy showed better ASES (p < 0.0001) and lower VAS pain score (p = 0.0249) compared to an open approach. Biologic and synthetic reconstructions demonstrated better results over osteosynthesis techniques. Biologic techniques showed overall better Constant (p = 0.0001) and DASH (p = 0.0215) scores, while synthetic reconstruction showed better UCLA score (p = 0.0001). Among suture buttons, triple button showed overall better results in Constant (p = 0.0001) and VAS (p = 0.0001) scores, while better results in DASH score (p = 0.0003) were achieved by 2 double button techniques. Overall, the level of evidence was low. Conclusion Biological and synthetic reconstructions achieved better functional scores compared to osteosynthesis. Among suture buttons, the triple button showed better functional performance. Level of evidence IV.

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“…[64] Others have reported no increase in ACJ osteoarthritis with CC fixation which did not violate ACJ. [6566] The proponents of retention of lateral clavicle site the biomechanical studies which have shown the importance of the AC ligaments and capsule to the stability of lateral end of clavicle during both small and large amounts of loading. [67–70] They argue that given the young age and sporting activity level of the typical patient with ACJ dislocation, retention of lateral end of clavicle can be potentially advantageous.…”

Section: Discussionmentioning

confidence: 99%

Clinical results of coracoacromial ligament transfer in acromioclavicular dislocations: A review of published literature

Sood

Wallwork

Bain

2008

Int J Shoulder Surg

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Acromioclavicular joint dislocations are common injuries, which typically occur with trauma in young men. Treatment recommendations for these injuries are highly variable and controversial. There are greater than 100 surgical techniques described for operative treatment of this injury. One of the most widely recommended methods of surgical reconstruction for acromioclavicular joint dislocations is to utilize the coracoacromial ligament for stabilization of the distal clavicle. Several modifications of this procedure have been described which have involved adjunct coracoclavicular fixation or fixation across acromioclavicular joint. Although the literature is replete with descriptive papers, there is paucity of studies evaluating the surgical outcome of this procedure. We systematically reviewed the English language published literature in peer reviewed journals (Medline, EMBASE, SCOPUS) and assigned a level of evidence for available studies. We critically reviewed each paper for the flaws and biases and then evaluated the comparable clinical outcomes for various procedures and their modifications. The published literature consists entirely of case series (Level IV evidence) with variability in surgical technique and outcome measures. On review there is low level evidence to support the use of coracoacromial ligament for acromioclavicular dislocation but it has been associated with high rate of deformity recurrence. Adjunct fixation does not improve clinical results when compared to isolated coracoacromial ligament transfer. This is in part because of the high incidence of fixation related complications. Similar results are reported with coracoacromial ligament reconstruction for acute and chronic cases. The development of secondary acromioclavicular joint symptoms with distal clavicle retention is poorly reported with the incidence rate varying from 12% to 32%. Despite this, the retention or excision of distal clavicle did not affect overall clinical results except in the patients with pre existing acromioclavicular joint osteoarthritis who have inferior results with retention of distal end of clavicle. Further well designed clinical trials with validated outcome measures are required to fully evaluate the clinical results of this procedure.

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Coracoclavicular Wiring for Acromioclavicular Joint Dislocation:A Ten Year Follow-up Study

Cited by 18 publications

References 9 publications

Vergleich und Ergebnis von Schultereckgelenkverletzungen II. und III. Grades

Vergleich und Ergebnis von Schultereckgelenkverletzungen II. und III. Grades

Biologic and synthetic ligament reconstructions achieve better functional scores compared to osteosynthesis in the treatment of acute acromioclavicular joint dislocation

Clinical results of coracoacromial ligament transfer in acromioclavicular dislocations: A review of published literature

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