Fracture Clavicle with Acromioclavicular Dislocation: A Complex Injury

Kakwani, Rajesh; Tourret, Lisa J.

doi:10.1111/j.1758-5740.2010.00102.x

Cited by 5 publications

(6 citation statements)

References 7 publications

(8 reference statements)

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“…Previous surgical options such as those employing Steinmann pins,1–3 K-wires,4 cortical screws2 5 6 and clavicular hook plates,7–10 all required implant removal once the coracoclavicular ligament healed. Recently, in two cases, tightrope technology for ACJ stabilisation was employed (emulating the same success seen in cruciate ligament reconstruction in the knee) and was found to produce satisfactory outcomes 11 12…”

Section: Discussionmentioning

confidence: 96%

“…In the early 1990s and 2000s, clavicle fractures were predominantly managed conservatively 1–4 13 14. Only recently has the trend drastically shifted towards open reduction and internal fixation with reconstruction plates5 9 15 or precontoured locking plates 6–8 11 12 16. In our patient, as the stabilisation of the coracoclavicular assembly using a dog bone button by passing fibre tape between the coracoid and the lateral half of the clavicle was contemplated, the mid-shaft fracture (despite being undisplaced) required stabilisation to prevent further displacement.…”

Section: Discussionmentioning

confidence: 99%

“…On the contrary, treatment options for acute high-grade ACJ (Rockwood classification: types III, IV, V and VI) injuries are gradually evolving with better understanding of shoulder biomechanics and implant technology; from the era of non-operative management (closed reduction) to varieties of internal fixation such as Steinmann pins,1–3 K-wires,4 cortical screws2 5 6 and clavicular hook plates 7–10. With the advent of arthroscopy, it is now possible to achieve a stable ACJ reduction (by restoring the coracoclavicular relationship) using two new techniques: tightrope,11 12 and recently, dog bone button (Arthrex, USA). This is the first case describing the utility of the latter.…”

Section: Introductionmentioning

confidence: 99%

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A dual injury of the shoulder: acromioclavicular joint dislocation (type IV) coupled with ipsilateral mid-shaft clavicle fracture

et al. 2015

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A direct blow to the shoulder, as may be sustained in a road traffic accident (RTA), can result in various combinations of fracture dislocations in the shoulder joint complex. Among these, a rare variety is an acromioclavicular joint (ACJ) dislocation coupled with ipsilateral mid-shaft clavicle fracture. Diverse treatment options have been described in the literature, ranging from non-operative and operative, to hybrid management. Treatment for this complex injury is predominantly dictated by the type of dislocation and displacement of the clavicle fracture, as well as age and demand of the patient. Acute high grades of ACJ dislocation require restoration of the coracoclavicular relationship (in place of torn coracoclavicular (CC) ligament) by some form of internal fixation, thereby maintaining the ACJ reduction. An arthroscopic reinstatement of the coracoclavicular relationship using a dog bone button and fibre tape implant for this composite injury pattern has not been previously described. Furthermore, a comprehensive review of the literature associated with this injury pattern is briefly described.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A dual injury of the shoulder: acromioclavicular joint dislocation (type IV) coupled with ipsilateral mid-shaft clavicle fracture

et al. 2015

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“…The surgical treatment of this shoulder injury has been described in the literature. The treatment of clavicular fractures is divided into nonsurgical treatment, plates, and intramedullary nailing, while the options for ACJ dislocation are elastic fixation (TightRope fixation system, [7,8] dog bone button, [9] reconstruction with tendon allograft, [10] or preloaded suture fixation [11] ) and rigid fixation (Kirschner wires, [12][13][14][15] clavicular hook plate, [16][17][18][19][20] and screw fixation [21][22][23] ) or a combination of both. [24] However, there is still a lack of consensus about the most appropriate way to treat this shoulder injury.…”

Section: Introductionmentioning

confidence: 99%

Mid-clavicle fracture with dislocation of the ipsilateral acromioclavicular joint treated with Endobutton system

Gao¹,

Cai²,

Yao³

et al. 2021

Medicine

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Rationale: Acromioclavicular joint (ACJ) dislocation combined with ipsilateral midclavicular fracture is extremely unusual and is a high-energy injury to the shoulder. A review of the literature divides the treatment of clavicular fractures is divided into nonsurgical treatment, plates, and intramedullary nailing, while the options for ACJ dislocation are elastic fixation and rigid fixation. However, there is still a lack of consensus about the most appropriate way to treat this shoulder injury. This case report involves a mid-clavicle fracture with dislocation of the ipsilateral ACJ, which was classified as type V according to Rockwood classification.Patient concerns: A 65-year-old man came to the emergency department after a traffic accident in which he was driving a motorcycle that collided with another motorcycle and his right shoulder collided directly with the ground. Digital radiography (DR) and computed tomography (CT) scans of the right shoulder joint showed mid-clavicle fracture with dislocation of the ipsilateral ACJ, which was classified as type V according to Rockwood classification.Diagnoses: The diagnosis of mid-clavicle fracture with dislocation of the ipsilateral ACJ was confirmed by DR and CT. Interventions:The patient was treated with a clavicle plate combined with the double Endobutton technique.Outcomes: After a 6-month follow up, the patient had excellent results for shoulder range of motion and functional. The patient's Constant-Murley score is 92.Lessons: Mid-clavicular fracture with a high-energy injury is highly suspicious and requires perfect shoulder CT or bilateral shoulder stress position DR to confirm whether there is a combined ACJ dislocation.

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“…In other case reports, the ACJ disruption grade is not stated, and the injury treatment was based on surgeon preference 5,6. Several options have been described for the treatment of grade III-VI ACJ injuries including Steinmann pins and cortical screws,7 clavicular hook plates,8 TightRope,9 Dog Bone button fixation, and autograft/allograft coracoclavicular ligament reconstruction techniques10; but none have been determined a gold-standard for stabilization of a concomitant clavicle fracture and ACJ injury.…”

mentioning

confidence: 99%

Coracoclavicular Ligament Reconstruction Using TightRope for Delayed Grade III Acromioclavicular Joint Injury After Ipsilateral Diaphyseal Clavicle Fracture Fixation: Surgical Technique and Review of Current Literature

Fulton

Singleton

Miller

2022

Techniques in Hand &Amp; Upper Extremity Surgery

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Athletes commonly sustain high-energy direct impact injuries to the shoulder, with acromioclavicular joint (ACJ) injuries accounting for over half. Ipsilateral ACJ injury and diaphyseal clavicle fracture occur nearly 7% of the time. There is limited literature offering treatment suggestions for this unique injury pattern and limited evidence providing guidance to suggest which injury patterns should be treated operatively or nonoperatively. Here, we present successful treatment of a high-level athlete utilizing a Knotless TightRope XP placed through a superior clavicle plate with successful return to full activity at 6 months postoperation. The TightRope technique offers the ability to augment through a preexisting superior clavicular plate in a low-profile manner and promote easy suture tensioning to obtain and maintain reduction of the injured ACJ.

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Fracture Clavicle with Acromioclavicular Dislocation: A Complex Injury

Cited by 5 publications

References 7 publications

A dual injury of the shoulder: acromioclavicular joint dislocation (type IV) coupled with ipsilateral mid-shaft clavicle fracture

A dual injury of the shoulder: acromioclavicular joint dislocation (type IV) coupled with ipsilateral mid-shaft clavicle fracture

Mid-clavicle fracture with dislocation of the ipsilateral acromioclavicular joint treated with Endobutton system

Coracoclavicular Ligament Reconstruction Using TightRope for Delayed Grade III Acromioclavicular Joint Injury After Ipsilateral Diaphyseal Clavicle Fracture Fixation: Surgical Technique and Review of Current Literature

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