The biomechanical influence of the deltotrapezoid fascia on horizontal and vertical acromioclavicular joint stability

Pastor, Marc-Frederic; Averbeck, A. K.; Welke, Bastian; Smith, Tomas; Claaßen, Leif; Wellmann, Mathias

doi:10.1007/s00402-015-2389-1

Cited by 26 publications

(22 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A recent biomechanical study looking at the horizontal stabilizing effect of the delto-trapezial fascia (DTF) concluded that a combined lesion of the AC ligaments and DTF resulted in significantly more anterior rotation and lateral translation of the distal clavicle-however, these differences were quantitatively small and of questionable clinical relevance. 27 Possible complications might include persistent instability despite repair, loss of reduction over time, fractures of the clavicle or coracoid, endobutton slippage and neurovascular injury, though in our series we did not encounter any of these. Another potential problem would be difficulty in deploying the endobutton through the coracoid, necessitating conversion to open surgery.…”

Section: Discussionmentioning

confidence: 58%

Percutaneous endobutton fixation of acute acromioclavicular joint injuries and lateral clavicle fractures

Manohara

Reid

2019

Journal of Clinical Orthopaedics and Trauma

View full text Add to dashboard Cite

Introduction: This paper describes a novel technique developed by the senior author to address acute acromioclavicular joint (ACJ) dislocations and certain distal clavicle fractures. Methods: The procedure employs a four strand, single tunnel, double endobutton repair performed entirely percutaneously, without any arthroscopic guidance or deep surgical dissection. Results: We present the preliminary results from our series of 6 consecutive patients performed over a period of 18 months. The mean length of surgery was 36min (range 32e40) and the mean correction of coracoclavicular (CC) distance achieved was 12.6 mm (range 10.3e14.1). There was no restriction of movement in any of the patients post-operatively and their average QuickDASH scores at final follow-up was 4.2 (range 0e6.8). Conclusion: Results in the present series were at least comparable to those for other techniques, validating percutaneous treatment as a solution for acute ACJ dislocations.

show abstract

Section: Discussionmentioning

confidence: 58%

Percutaneous endobutton fixation of acute acromioclavicular joint injuries and lateral clavicle fractures

Manohara

Reid

2019

Journal of Clinical Orthopaedics and Trauma

View full text Add to dashboard Cite

show abstract

“…Besides that, interposition of the deltotrapezial fascia in the acromioclavicular joint previous to reduction is avoided, and the risk of incomplete acromioclavicular joint reduction, particularly in grade V dislocations, is minimized ( Table 3 ). 6 The importance of this structure to AC stabilization has been described previously, and its incorrect closure is one of the most commons pitfalls in AC surgery. 6 , 7 , 8 …”

Section: Discussionmentioning

confidence: 85%

“… 6 The importance of this structure to AC stabilization has been described previously, and its incorrect closure is one of the most commons pitfalls in AC surgery. 6 , 7 , 8 …”

Section: Discussionmentioning

confidence: 85%

See 1 more Smart Citation

A Technique for a More Accurate Acromioclavicular Joint Reduction in Arthroscopic Coracoclavicular Stabilization of Acromioclavicular Joint Dislocation

Leite

Dias

Nunes

et al. 2021

Arthroscopy Techniques

View full text Add to dashboard Cite

Loss of reduction is the most common complication following acromioclavicular dislocations treatment, with literature showing greater postoperative coracoclavicular distances associated with worse clinical results. We present a surgical gesture that aims to help surgeons achieve and secure an anatomic acromioclavicular reduction during coracoclavicular fixation. This technique has the possibility to improve radiological and functional results of acromioclavicular dislocation treatment.

show abstract

“…16 , 27 , 28 Some hypothesize that the deltoid-trapezius complex works in synchrony to provide dynamic stability to the AC joint. 16 , 29 This equilibrium is disrupted with AC joint injuries. In fact, Lizaur et al identified that 94% of patients with AC joint separations had injury to the trapezius and/or deltoid.…”

Section: Discussionmentioning

confidence: 99%

Acromioclavicular Joint Injuries: Effective Rehabilitation

LeVasseur¹,

Mancini²,

Berthold³

et al. 2021

OAJSM

View full text Add to dashboard Cite

Purpose To perform a review of the literature focusing on rehabilitation protocols in patients with acromioclavicular (AC) joint injuries treated operatively and nonoperatively and to provide an updated rehabilitation treatment algorithm. Methods Studies were identified by searching the MEDLINE database from 01/1995 to 09/2020. Included studies contained detailed rehabilitation protocols with physiologic rationale for AC joint injuries. Biomechanical studies, technique articles, radiographic studies, systematic reviews, case studies, editorials, and studies that compared nonoperative versus operative treatment without focus on rehabilitation were excluded. Following identification of the literature, an updated treatment algorithm was created. Results The search strategy yielded 1742 studies, of which 1654 studies were excluded based on title, 60 on the abstract, and 25 on the full manuscript. One study was manually identified using article reference lists, yielding four publications presenting detailed rehabilitation protocols based on physiologic rationale. No randomized controlled trials or comparative studies were identified or cited as a basis for these rehabilitation protocols. Conclusion Few detailed rehabilitation protocols in patients with AC joint injuries have been published. These protocols are limited by their standardization, arbitrary timelines, and provide minimal assessment of individual patient characteristics. The quality of patient care can be improved with more practical guidelines that are goal-oriented and allow for critical thinking among clinicians to address individual patient needs. Three common barriers preventing successful rehabilitation were identified and addressed: Pain, Apprehension, and (anterior chest wall) Stiffness to regain Scapular control, effectively termed “PASS” for AC joint rehabilitation. Clinical Relevance Rehabilitation protocols for AC joint injuries should be less formulaic and instead allow for critical thinking and effective communication among clinicians and therapists to address individual patient needs.

show abstract

The biomechanical influence of the deltotrapezoid fascia on horizontal and vertical acromioclavicular joint stability

Cited by 26 publications

References 24 publications

Percutaneous endobutton fixation of acute acromioclavicular joint injuries and lateral clavicle fractures

Percutaneous endobutton fixation of acute acromioclavicular joint injuries and lateral clavicle fractures

A Technique for a More Accurate Acromioclavicular Joint Reduction in Arthroscopic Coracoclavicular Stabilization of Acromioclavicular Joint Dislocation

Acromioclavicular Joint Injuries: Effective Rehabilitation

Contact Info

Product

Resources

About