Modified Phemister procedure for the treatment of type III Rockwood acromioclavicular joint dislocation. Results after five-years follow-up

2010 ◽  
Vol 54 (5) ◽  
pp. 294-300
Author(s):  
N. Muñoz García ◽  
F. Tomé Bermejo
Keyword(s):  
Acromioclavicular Joint ◽  
Acromioclavicular Joint Dislocation ◽  
Joint Dislocation ◽  
Type Iii

scholarly journals A modified single-endobutton technique combined with nice knot for treatment of Rockwood type III or V acromioclavicular joint dislocation

2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Fangning Hu ◽  
Shumei Han ◽  
Fanxiao Liu ◽  
Zhuang Wang ◽  
Honglei Jia ◽  
...  
Keyword(s):  
Acromioclavicular Joint ◽  
Operative Time ◽  
Acromioclavicular Joint Dislocation ◽  
Intraoperative Blood Loss ◽  
Joint Dislocation ◽  
Type Iii ◽  
The Mean ◽  
The Difference ◽  
Rockwood Type Iii

Abstract Purpose Double-endobutton technique, as a widely accepted strategy for the treatment of acromioclavicular joint dislocation, is undergoing constant improvement. This study aims to assess the clinical effect of a modified single-endobutton combined with the nice knot in the fixation of Rockwood type III or V acromioclavicular joint dislocation. Methods From January 2016 to June 2019, 16 adult patients (13 males and 3 females) with Rockwood type III or V acromioclavicular joint dislocation were treated with a modified single-endobutton technique combined with the nice knot in our department. The age ranged from 18 to 64 years old with an average of 32.8 years old. Operative time, intraoperative blood loss, post-operative clinical outcomes and radiographic results were recorded and analyzed. Preoperative and last follow-up scores in the Constant-Murley Scale, Neer score, Rating Scale of the American Shoulder and Elbow Surgeons and VAS scale and complications such as infection, re-dislocation, implant loosening, medical origin fracture and hardware pain were recorded and evaluated. Results Sixteen patients were followed up for 6 to 18 months with an average of 10.3 months. The operative time was 50–90 min with an average of (62.5 ± 3.10) min. The intraoperative blood loss was 30–100 ml, with an average of (55.0 ± 4.28) ml. The complications, such as wound infection, internal fixation failure and fractures, were not found in these cases. According to Karlsson criteria, there were excellent in 14 cases, good in 2 cases at the final follow-up. The mean VAS score of the patients was 5.88 ± 0.26 preoperatively, compared with 0.19 ± 0.14 at the final follow-up evaluation. The difference was statistically significant (P < 0.05). The mean Constant score was 45.5 ± 2.0 preoperatively, compared to 94.0 ± 0.73 at the final follow-up evaluation. The difference was statistically significant (P < 0.05). Patients had statistically significant preoperative and postoperative AC (acromioclavicular distance) and CC (coracoclavicular distance) distances (P < 0.05); 6 months postoperatively the AC(P = 0.412) and CC(P = 0.324) distances were not statistically significant compared to the healthy side. Conclusion Nice knot provides a reliable fixation for the single-endobutton technique in the treatment of acromioclavicular dislocations. The modified single-endobutton technique combined with the nice knot can achieve good clinical outcomes in the treatment of Rockwood type III or V acromioclavicular joint dislocation.

scholarly journals A Modified Single-Endobutton Technique Combined with Nice Knot for Treatment of Rockwood Type III Acromioclavicular Joint Dislocation

2021 ◽  
Author(s):  
Fangning Hu ◽  
Shumei Han ◽  
Fanxiao Liu ◽  
Zhuang Wang ◽  
Honglei Jia ◽  
...  
Keyword(s):  
Acromioclavicular Joint ◽  
Operative Time ◽  
Acromioclavicular Joint Dislocation ◽  
Intraoperative Blood Loss ◽  
Joint Dislocation ◽  
Type Iii ◽  
The Mean ◽  
The Difference ◽  
Rockwood Type Iii

Abstract Purpose: Double-endobutton technique, as a widely accepted strategy for the treatment of acromioclavicular joint dislocation , is undergoing constant improvement. This study was to assess the clinical effect of a modified single-endobutton combined with nice knot in the fixation of Rockwood type III acromioclavicular joint dislocation.Methods: From January 2016 to January 2018, 16 adult patients (13 males and 3 females) with Rockwood type III acromioclavicular joint dislocation were treated with a modified single-endobutton technique combined with nice knot in our department. The age ranged from 18 to 64 years old with an average of 32.8 years old. Operative time and intraoperative blood loss were recorded, post-operative clinical outcomes and radiographic results were recorded and analyzed. Preoperative and last follow up scores in the Constant-Murley Scale, Neer score, Rating Scale of the American Shoulder and Elbow Surgeons and VAS scale and complications such as infection, re-dislocation, implant loosening, medical origin fracture and hardware pain were recorded and evaluated. Results: 16 patients were followed up for 6 to 18 months with an average of 10.3 months. The operative time was 50-90 minutes with an average of (62.5±3.10) min. The intraoperative blood loss was 30-100 ml, with an average of (55.0±4.28) ml. The complications, such as wound infection, internal fixation failure and fractures, were not found in these cases. According to Karlsson criteria, there were excellent in 14 cases, good in 2 cases at the final follow up. The mean VAS score of the patients was 5.88±0.26 preoperatively, compared with 0.19±0.14 at the final follow-up evaluation. The difference was statistically significant (P<0.01). The mean Constant score was 45.5±2.0 preoperatively, compared to 94.0±0.73 at the final follow-up evaluation. The difference was statistically significant (P<0.01). Conclusion: Nice knot provides a reliable fixation for the single-Endobutton technique in the treatment of acromioclavicular dislocations. The modified single-Endobutton technique combined with nice knot can achieve good clinical outcomes in treatment of Rockwood type III acromioclavicular joint dislocation.

scholarly journals The relationship between chronic type III acromioclavicular joint dislocation and cervical spine pain

2009 ◽  
Vol 10 (1) ◽  
Author(s):  
Stefano Gumina ◽  
Stefano Carbone ◽  
Valerio Arceri ◽  
Alessandro Rita ◽  
Anna R Vestri ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Acromioclavicular Joint ◽  
Acromioclavicular Joint Dislocation ◽  
Chronic Type ◽  
Joint Dislocation ◽  
Type Iii ◽  
Spine Pain ◽  
The Relationship

scholarly journals Risk Factors for postoperative shoulder pain of acromioclavicular joint dislocation treat with hook plate

2020 ◽  
Author(s):  
Ding Xu ◽  
Weigang Lou ◽  
Peng Luo ◽  
Yulong Shi ◽  
Weijun Guo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Shoulder Pain ◽  
Acromioclavicular Joint ◽  
Hook Plate ◽  
Acromioclavicular Joint Dislocation ◽  
Joint Dislocation ◽  
Significant Independent Risk Factor ◽  
Lost To Follow Up ◽  
Postoperative Shoulder

Abstract Background: Postoperative shoulder pain was a most common complication after clavicular hook plate treatment for acromioclavicular joint dislocation. However, the researches on its risk factors were rare. The purpose of this study was to evaluate the incidences of postoperative shoulder pain of acromioclavicular joint dislocation treat with hook plate and to identify risk factors in patients with an acute acromioclavicular joint dislocation. Method: We retrospectively analyzed the prospectively collected data from 310 consecutive patients with AC joint dislocation between December 2014 and August 2019 at our institute. Patients rated the average intensity of shoulder pain using an 11-point numerical rating scale (NRS). The dependent variable was the presence of moderate-to-severe neck pain (NRS ≥4) at the last follow-up when the internal fixation will be removed. The independent variables included age, gender, body-mass index (BMI), smoking status, alcohol consumption, type of injury, Rockwood Classification, site of injury, operation time, injury-to-surgery, DHA, DH and AHP. Logistic regression analysis was performed to identify independent risk factors of moderate-to-severe shoulder pain of acromioclavicular joint dislocation treat with hook plate. Results: A total of 292 patients were included in the study and 18 cases were lost to follow-up. The follow-up rate was 94.1%. In all cases, there were 166 male cases and 126 female cases. Of these cases, the NRS < 4 group had 219 patients. Among them, there were 120 males and 99 females. 12 patients were lost to follow-up. There were 73 patients in NRS ≥ 4 group, 46 males and 27 females. 6 cases were lost to follow-up. The number of patient in NRS ≥ 4 group accounted for about 25.0% of the total cases. DH was the significant independent risk factor for postoperative shoulder pain of acromioclavicular joint dislocation treat with hook plate. DHA and AHP were also independent factors of postoperative shoulder pain, but they were all protective. Conclusions: DH was the significant independent risk factor for postoperative shoulder pain of acromioclavicular joint dislocation treat with hook plate. DHA and AHP were also independent factors of postoperative shoulder pain, but they were all protective. We should try to refer to these factors to avoid postoperative shoulder pain when performing clinical operations.

scholarly journals Modified Weaver-Dunn Procedure for Type 3 Acromioclavicular Joint Dislocation: Functional and Radiological Outcomes

2020 ◽  
Vol 8 (3) ◽  
pp. 232596712090502
Author(s):  
Olimpio Galasso ◽  
Lorenzo Tarducci ◽  
Massimo De Benedetto ◽  
Nicola Orlando ◽  
Michele Mercurio ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Acromioclavicular Joint ◽  
Acromioclavicular Joint Dislocation ◽  
Joint Stability ◽  
Healthy Individuals ◽  
Chronic Type ◽  
Joint Dislocation ◽  
Constant Murley Score ◽  
Type 3

Background Controversy surrounds the indication for treatment of type 3 acromioclavicular joint dislocation, and the optimal reconstructive technique has not yet been defined. Since the first description of the Weaver-Dunn procedure, several studies have described the clinical and radiological results that can be expected postoperatively; however, few studies have evaluated the outcomes of this technique for chronic type 3 acromioclavicular joint dislocation. Purpose/Hypothesis The purpose of this study was to evaluate the functional and radiographic mid- to long-term outcomes of a modified Weaver-Dunn procedure for chronic Rockwood type 3 acromioclavicular joint dislocation. We hypothesized that (1) functional outcomes comparable with sex- and age-matched healthy individuals could be achieved with the modified Weaver-Dunn procedure and (2) joint stability could be restored after surgery. Study Design Case series; Level of evidence, 4. Methods Out of 30 patients who sustained a chronic type 3 acromioclavicular joint dislocation, 27 had a minimum 12-month follow-up and were included in the study. All patients underwent a modified Weaver-Dunn procedure. The Constant-Murley score was used to assess patient postoperative function. Subjective evaluation of patient satisfaction with surgery was also recorded. Radiological assessment was performed postoperatively to evaluate superoinferior and anteroposterior joint stability. Results After a mean follow-up period of 51.6 months, the mean Constant-Murley score was 90.1, which was 97.2% that of a group of sex- and age-matched healthy individuals. In the multivariate analysis, higher Constant-Murley score was associated with male sex (β = 0.385; P = .043) and higher subjective satisfaction scale (β = 0.528; P = .003). All patients returned to their previous work and sport activity levels having high satisfaction with surgery. Successful vertical acromioclavicular joint reduction was obtained in all but 1 patient; however, horizontal joint stability was not completely restored with the modified Weaver-Dunn procedure. No intraoperative complications occurred, and the postoperative complication rate was 7.4%. Conclusion In patients with chronic type 3 acromioclavicular joint dislocation, the modified Weaver-Dunn procedure is an effective technique to restore vertical but not horizontal joint stability 4 years after surgery. High levels of satisfaction with surgery and functional outcomes comparable with sex- and age-matched healthy individuals can be achieved.

scholarly journals Clinical and radiological results after coracoclavicular ligament reconstruction for type III acromioclavicular joint dislocation using three different techniques. A retrospective study

Joints ◽  
2015 ◽  
Vol 03 (02) ◽  
pp. 54-61 ◽  
Author(s):  
Alberto Vascellari ◽  
Stefano Schiavetti ◽  
Giuseppe Battistella ◽  
Enrico Rebuzzi ◽  
Nicolò Coletti
Keyword(s):  
Retrospective Study ◽  
Acromioclavicular Joint ◽  
Constant Score ◽  
Acromioclavicular Joint Dislocation ◽  
Dash Score ◽  
X Rays ◽  
Level Of Evidence ◽  
Type Iii ◽  
Joint Dislocations

Purpose: the purpose of this retrospective study was to present the outcomes of three different techniques for the treatment of type III acromioclavicular joint dislocations: arthroscopic TightRope (TR), arthroscopic GraftRope (GR), and open reconstruction of the coracoclavicular (CC) ligament using the Ligament Augmentation and Reconstruction System (LARS). Methods: eighteen patients underwent clinical and radiological evaluations after a mean follow-up time of 43 months. The following clinical outcome measures were considered: the Disability of the Arm, Shoulder and Hand outcome measure (DASH), the Nottingham Clavicle Score (NCS), and the Constant score (CS). On X-rays, the CC distance was measured. Results: the median DASH score at follow-up was 12.5 in the TR group, 5 in the GR group, and 4.2 in the LARS group. The median NCS value was 88 in the TR group, 88 in the GR group, and 91 in the LARS group. The median CS was 100 in the TR group, 95 in the GR group, and 94.5 in the LARS group. The mean CC distance was 10.3 mm in the TR group, 13.8 in the GR group, and 16.6 in the LARS group. Conclusions: all three techniques proved to be reliable in providing good clinical outcomes, although none of the studied techniques demonstrated reliability in maintaining anatomical reduction after surgery. Level of evidence: Level III, retrospective comparative study.

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