Clinical outcomes of arthroscopic and navigation-assisted two tunnel technique for coracoclavicular ligament augmentation of acute acromioclavicular joint dislocations

Abstract Background The purpose of this study was to present a navigated image-free augmentation technique for the acromioclavicular joint (ACJ) and coracoclavicular (CC) ligaments and to report the clinical and radiological outcomes. Methods From 2013 to 2018, 35 eligible patients were treated with our navigated image-free ACJ- and CC-augmentation technique. The average follow-up was 3 years. Follow-up evaluations included the Constant-Murley Score, subjective shoulder value, Taft score, and the acromioclavicular joint instability (ACJI) score. The patients’ quality of life was assessed using the EuroQol-5D (EQ-5D) questionnaire. In addition, in accordance with the instability criteria, radiographs were evaluated before surgery, after surgery, and during follow-up. Results Overall, 25 patients (71%) suffered an acute type V disruption, 5 (14%) had a type IV disruption, and 5 (14%) had an acute Rockwood type IIIb injury. The mean Constant-Murley Score was 90 (range: 56–100; p = 0.53) on the injured side, and the mean subjective shoulder value was 92% (range: 80–100%). The mean Taft and ACJI scores were 10 (range: 4–12) and 86 (range: 34–100), respectively and the mean EQ-5D was 86 (range: 2–100). The mean CC difference of the injured side was 4 mm (range: 1.9–9.1 mm) at follow-up, which was not significantly different than that of the healthy side (p = 0.06). No fractures in the area of the clavicle or the coracoid were reported. Conclusions The arthroscopic- and navigation-assisted treatment of high-grade ACJ injuries in an anatomical double-tunnel configuration yields similar clinical and radiological outcomes as the conventional technique using an aiming device. Precise positioning of the navigation system prevents multiple drillings, which avoids fractures.

Download Full-text

Treatment of Acute Acromioclavicular Joint Dislocations Type III and Type V by Rockwood Classification Using a Dynamic Stabilization System under Arthroscopic Control with and without Suture of the Ligaments of the Acromioclavicular Joint

Visnyk Ortopedii Travmatologii Protezuvannia ◽

10.37647/0132-2486-2021-108-1-5-12 ◽

2021 ◽

pp. 5-12

Author(s):

S.O. Bezruchenko

Keyword(s):

Acromioclavicular Joint ◽

Dynamic Stabilization ◽

Stabilization System ◽

Rockwood Classification ◽

Injured Side ◽

Joint Dislocations ◽

Acromioclavicular Joint Instability ◽

The Mean ◽

Type V

Summary. Acute acromioclavicular (AC) joint dislocation is still a challenging task for orthopedic surgeons. Objective: to compare the clinical and radiological results of treatment of patients with acute dislocation of the acromial end of the clavicle who were treated with a dynamic stabilization system with and without suture of acromioclavicular ligaments under arthroscopic control. Materials and Methods. A retrospective analysis of the treatment of 44 patients with acute AC joint dislocations type III and type V by Rockwood classification was performed. The patients were divided into 2 groups: group I – 18 patients (40.9%) who underwent stabilization of the dislocation and fixation of the acromial end of the clavicle using a dynamic stabilization system and suture of the ligaments of the acromioclavicular joint under arthroscopic control; group II – 26 patients (59.1%) who underwent stabilization of the dislocation and fixation of the acromial end of the clavicle using a dynamic stabilization system without suture of the ligaments of the acromioclavicular joint under arthroscopic control. There were 40 male (90.9%) and 4 female (9.1%) patients aged 18–58 years (mean age 32.9±10.1 years). The mean time from injury to surgical treatment was 8.3±3.2 days (from 3 to 17 days). Clinical observation was carried out at an average time of 20.1±3.9 months after surgery (from 12 to 28 months). Clinical outcomes were assessed using the Oxford Shoulder scale, the Constant-Murley scale, and the Acromioclavicular Joint Instability Scoring System. Results. The mean Oxford Shoulder score at the final follow-up on the injured side was 45.8±1.3 points and 46.2±1.3 points (p=0.422) in groups I and II, respectively. The mean Constant-Murley score at the final follow-up on the injured side was 94.6±2.4 points and 91.7±4.2 points (p=0.0134) in groups I and II, respectively. The mean score on the Acromioclavicular Joint Instability Scoring System at the final follow-up on the injured side was 83.8±7.1 points and 78.1±11.8 points (p=0.075) in groups I and II, respectively. No significant complications were observed in both groups. Conclusions. The combination of the arthroscopically assisted technique of reconstruction of the acromioclavicular ligaments using high-strength sutures and fixation of the coracoclavicular ligaments using a dynamic stabilization system provides good long-term clinical results.

Download Full-text

Operative Versus Non-operative Treatment of Grade III Acromioclavicular Joint Dislocations and the Use of SurgiLig: a Retrospective Review

Ortopedia Traumatologia Rehabilitacja ◽

10.5604/01.3001.0010.8043 ◽

2017 ◽

Vol 19 (6) ◽

pp. 523-530 ◽

Cited By ~ 3

Author(s):

Fizan Younis ◽

Sanil Ajwani ◽

Asia Bibi ◽

Eleanor Riley ◽

Peter J. Hughes

Keyword(s):

Operative Treatment ◽

Retrospective Review ◽

Acromioclavicular Joint ◽

Shoulder Girdle ◽

Joint Dislocations ◽

Significant Difference ◽

Synthetic Ligament ◽

The Mean ◽

Grade Iii

Background. Acromioclavicular joint dislocations are common shoulder girdle injuries. The treatment of grade III acromioclavicular joint dislocations is controversial. Furthermore, the literature on the use of the SurgiligTM synthetic ligament for reconstruction of dislocations is sparse. Materials and methods. This retrospective review aimed to establish whether operative treatment was superior to non-operative treatment in grade III acromioclavicular joint dislocations treated at our institute over a 5-year period. We also reviewed the effectiveness of reconstruction with SurgiligTM after acute and chronic dislocations across all grades of acromioclavicular joint dislocations. Results. Twenty-five patients completed full follow-up with grade III dislocations. The mean follow-up in the operated group was 3.56 years and in the non-operated group this was 3.29 years. The mean Oxford Shoulder Score (OSS) in the operated group was 39.8, whereas the mean OSS in the non-operated group was 45.9 (p=0.01). The mean pain score in the operated group was 2.2, and in the non-operated group this was 1.6. The mean satisfaction score in the operated group was 8.2 and that in the non-operated group was 7.8. There was no statistically significant difference in pain or satisfaction scores. In respect to the cohort treated with SurgiligTM synthetic ligament, 22 patients across all grades of dislocations had this procedure performed. The mean post-operative Oxford Shoulder Score (OSS) was 40. Conclusions. 1. Non-operative treatment is not inferior to operative treatment for grade III acromioclavicular joint dislocations. The data from this study demonstrated that the non-operated group had superior Oxford Shoulder Scores that were statistically significant. 2. Additionally, the use of the SurgiligTM ligament appears to be effective in treating both chronic and acute acromioclavicular joint dislocations.

Download Full-text

Weighted or internal rotation radiographs are not useful in the classification of acromioclavicular joint dislocations

Acta Radiologica ◽

10.1177/0284185120939270 ◽

2020 ◽

pp. 028418512093927

Author(s):

Jonas S Nordin ◽

Felicia Mogianos ◽

Anders Hauggaard ◽

Karl Lunsjö

Keyword(s):

Confidence Interval ◽

Internal Rotation ◽

Acromioclavicular Joint ◽

High Grade ◽

Laboratory Studies ◽

Exclusion Criteria ◽

Injured Side ◽

Joint Dislocations ◽

The Mean

Background Weighted radiographs are performed to classify acromioclavicular joint dislocations; however, the evidence regarding their usefulness is conflicting. Laboratory studies suggest that internal rotation views can replace weighted radiographs, but this has not been clinically evaluated. Purpose To evaluate whether weighted or internal rotation radiographs uncovers more high-grade acromioclavicular joint dislocations than non-weighted radiographs. Material and Methods A total of 162 patients with acromioclavicular joint dislocations were prospectively included. After applying exclusion criteria, 140 remained. Three panorama radiographs, including both coracoclavicular intervals, were completed of each participant: first, a weighted radiograph with 5-kg weights suspended from the wrists; second, a non-weighted radiograph; and third, an internal rotation radiograph. The coracoclavicular intervals were measured by two radiologists independently, and measurements were translated into Rockwood classifications. The classifications and measurements derived from the different radiographic views were compared. Results Weighted radiographs caused no significant changes in classification. For the internal rotation views, there was a significant change in classification for radiologist 2; however, the reason was that more injuries were downgraded compared to the non-weighted views. Relative to the non-weighted radiographs, the mean increase of the coracoclavicular interval on the injured side in the weighted view was 0.5 mm (95% confidence interval [CI] 0.37–0.65) and in the internal rotation view 0.2 mm (95% CI 0.04–0.33). While these changes were statistically significant, they were small and not clinically important. Conclusion This study does not support the use of weighted and internal rotation radiographs in the classification of acromioclavicular joint dislocations.

Download Full-text

Treatment of Acute Acromioclavicular Joint Injuries Using AO Hook Locking Plate

Clinics in Shoulder and Elbow ◽

10.5397/cise.2014.17.3.114 ◽

2014 ◽

Vol 17 (3) ◽

pp. 114-119 ◽

Cited By ~ 1

Author(s):

Kyung Cheon Kim ◽

Yoo Sun Jeon

Keyword(s):

Los Angeles ◽

Acromioclavicular Joint ◽

Locking Plate ◽

Rating Scale ◽

Treatment Method ◽

Unaffected Side ◽

Joint Injuries ◽

Coracoclavicular Distance ◽

The Mean

BACKGROUND: To evaluate clinical and radiological outcome using AO hook locking plate in acute acromioclavicular joint injuries.METHODS: This study was based on patients with Rockwood type 3 or 5 acromioclavicular joint injuries who received surgery with AO hook locking plate from June 2008 until June 2009. Among the 22 patients, 19 of them were male and 3 were female, the mean age was 44.4 +/- 15.57 years (20-72 years) and follow-up period was 15.5 +/- 3.90 months (12-23 months). Preoperatively, postoperatively, and at the final follow-up after the plate removal, both coracoclavicular distances were measured from the anteroposterior radiograph. Also, the Shoulder Rating Scale of the University of California at Los Angeles scores (UCLA scores), the American Shoulder and Elbow Surgeons scores (ASES scores), Constant scores, and the Korean Shoulder Society scores (KSS scores) were measured at the final follow-up to evaluate the function of the shoulder joint.RESULTS: At the time of injury, the mean coracoclavicular distance of the injured side was 17.69 +/- 4.23 mm (9.57-27.82 mm) and the unaffected side was 7.55 +/- 2.20 mm (3.24-13.05 mm). The mean coracoclavicular distance measured postoperatively and at the final follow-up was 6.87 +/- 2.34 mm (4.07-14.13 mm) and 8.47 +/- 2.96 mm (4.37-17.48 mm), respectively. The mean UCLA, ASES, Constant, and KSS scores measured in the final follow-up were 33.5 +/- 1.30 (31-35), 90.8 +/- 8.36 (72-100), 78.6 +/- 8.80 (62-100), and 94.4 +/- 5.08 (84-100) each.CONCLUSIONS: From this short-term research, the surgical treatment using AO hook locking plates in acute acromioclavicular joint injuries is clinically and radiographically satisfying and considered as a useful treatment method.

Download Full-text

Clinical efficacy of treating the first metacarpal base fracture by closed reduction and percutaneous parallel K-wire interlocking fixation

10.21203/rs.3.rs-447849/v1 ◽

2021 ◽

Author(s):

Wu Wang ◽

Min Zeng ◽

Junxiao Yang ◽

Long Wang ◽

Jie Xie ◽

...

Keyword(s):

Clinical Efficacy ◽

Closed Reduction ◽

Fracture Group ◽

Articular Fracture ◽

Articular Fractures ◽

Injured Side ◽

Uninjured Side ◽

Flexion Extension ◽

The Mean

Abstract Objective: To explore the clinical efficacy of treating a first metacarpal base fracture by closed reduction and percutaneous parallel K-wire interlocking fixation between the first and second metacarpals.Methods: Twenty patients treated by the above technique from October 2015 to December 2018 at our institution were retrospectively reviewed. The patients’ average age was 36 years (range, 16–61 years). Eleven patients were extra-articular fractures and nine were intra-articular fractures. The mean follow-up period was 12 months (range, 10–18 months). At the final follow-up, the functional recovery of the injured hand was assessed and compared with that of the uninjured hand.Results: All patients recovered well with no complications. In the extra-articular fracture group, the mean hand grip strength, pinch strength, and Kapandji score were 43.4 ± 7.0 kg, 9.1 ± 1.4 kg, and 9.5 ± 0.7 on the injured side and 41.7 ±6.8 kg, 8.7 ± 0.8 kg, and 9.7 ± 0.5 on the uninjured side, respectively, with no significant differences. In the intra-articular fracture group, the above indexes were 43.0 ± 6.5 kg, 9.0 ± 1.1 kg, and 9.3 ± 0.7 on the injured side and 42.1 ± 6.6 kg, 8.6 ± 1.1 kg, and 9.7 ± 0.5 on the uninjured side, respectively, also with no significant differences. The abduction and flexion-extension arc of the thumb on the injured hand were lower than those on the uninjured hand in both the extra-articular and intra-articular fracture groups, but the patients felt clinically well with respect to daily activities and strength.Conclusion: The percutaneous parallel K-wire and the interlocking fixation technique is simple, effective, and economic for first metacarpal base fractures.

Download Full-text

Osteochondral allograft transplantation for large Hill-Sachs lesions: a retrospective case series with a minimum 2-year follow-up

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-019-1366-8 ◽

2019 ◽

Vol 14 (1) ◽

Cited By ~ 1

Author(s):

Hongwu Zhuo ◽

Yangkai Xu ◽

Fugui Zhu ◽

Ling Pan ◽

Jian Li

Keyword(s):

Clinical Outcomes ◽

Case Series ◽

Osteochondral Allograft ◽

Satisfaction Rate ◽

Allograft Transplantation ◽

Constant Murley Score ◽

Significant Difference ◽

The Mean ◽

Graft Resorption

Abstract Purpose To investigate the clinical outcomes after osteochondral allograft transplantation for large Hill-Sachs lesions. Methods Patients who underwent osteochondral allograft transplantation for large Hill-Sachs lesions were identified. Clinical assessment consisted of active range of motion (ROM), American Shoulder and Elbow Surgeons score (ASES), Constant-Murley score, Rowe score, and patient satisfaction rate. Radiographic assessment was performed with CT scan. Results Nineteen patients met the inclusion criteria. The mean age was 21.7 years. The mean preoperative size of the Hill-Sachs lesion was 35.70 ± 3.02%. The mean follow-up was 27.8 months. All grafts achieved union at an average of 3.47 months after surgery. At the final follow-up, graft resorption was observed in 43.1% of patients. The average size of residual humeral head articular arc loss was 12.31 ± 2.79%. Significant improvements (P < .001) were observed for the active ROM, ASES score, Constant-Murley score, and Rowe score. The overall satisfaction rate was 94.7%. No significant difference was found between the resorption group and the nonresorption group in postoperative clinical outcomes. Conclusion Osteochondral allograft transplantation is a useful treatment option for patients with large Hill-Sachs lesions. Although the incidence of graft resorption may be relatively high, the clinical outcomes at a minimum 2-year follow-up are favorable. Level of evidence Level IV, case series

Download Full-text

Anatomic reconstruction for acromioclavicular joint injuries: a pilot study of a cost-effective new technique

Clinics in Shoulder and Elbow ◽

10.5397/cise.2021.00325 ◽

2021 ◽

Vol 24 (4) ◽

pp. 209-214

Author(s):

Radhakrishnan Pattu ◽

Girinivasan Chellamuthu ◽

Kumar Sellappan ◽

Chendrayan Kamalanathan

Keyword(s):

Acromioclavicular Joint ◽

Cost Effective ◽

Anatomic Reconstruction ◽

X Rays ◽

Effective Technique ◽

Ac Joint ◽

Joint Injuries ◽

Cost Effective Technique ◽

The Mean

Background: The treatment for acromioclavicular joint injuries (ACJI) ranges from a conservative approach to extensive surgical reconstruction, and the decision on how to manage these injuries depends on the grade of acromioclavicular (AC) joint separation, resources, and skill availability. After a thorough review of the literature, the researchers adopted a simple cost-effective technique of AC joint reconstruction for acute ACJI requiring surgery.Methods: This was a prospective single-center study conducted between April 2017 and April 2018. For patients with acute ACJI more than Rockwood grade 3, the researchers performed open corococlavicular ligament reconstruction using synthetic sutures along with an Endobutton and a figure of 8 button plate. This was followed by AC ligament repair augmenting it with temporary percutaneous AC K-wires. Clinical outcomes were evaluated using the Constant Murley shoulder score. Results: Seventeen patients underwent surgery. The immediate postoperative radiograph showed an anatomical reduction of the AC joint dislocation in all patients. During follow-up, one patient developed subluxation but was asymptomatic. The mean follow-up period was 30 months (range, 24–35 months). The mean Constant score at 24 months was 95. No AC joint degeneration was noted in follow-up X-rays. The follow-up X-rays showed significant infra-clavicular calcification in 11 of the 17 patients, which was an evidence of a healed coracoclavicular ligament post-surgeryConclusions: This study presents a simple cost-effective technique with a short learning curve for anatomic reconstruction of acute ACJI. The preliminary results have been very encouraging.

Download Full-text

Subacromial Erosion after Hook Plate Fixation in Acute Acromioclavicular Joint Dislocation

10.21203/rs.3.rs-125960/v1 ◽

2020 ◽

Author(s):

Jung Youn Kim ◽

Yong Girl Rhee ◽

Young Wan Ko ◽

Sung Min Rhee

Keyword(s):

Risk Factors ◽

Computed Tomography ◽

Acromioclavicular Joint ◽

Plate Fixation ◽

Hook Plate ◽

Unaffected Side ◽

Ct Findings ◽

Ucla Score ◽

The Mean

Abstract Background: This study was to analyze the clinical results of locking hook plate fixation for acute acromioclavicular joint (ACJ) injury and to find out the incidence of subacromial erosion, carry out quantitative analysis and identify risk factors. Methods: The study was conducted on 35 patients who underwent the locking hook plate fixation for acute ACJ joint injury. The clinical outcomes were evaluated measuring the visual analog scale (VAS) for pain, and the University of California at Los Angeles (UCLA) score. The computed tomography (CT) was conducted to measure the subacromial erosion. The acromioclavicular slope (AC slope) of the unaffected side, the acromion-hook angle (AH angle), the acromioclavicular anteroposterior distance (AC-AP distance), and the preoperative acromioclavicular interval (ACI) of the affected side were analyzed to identify the risk factors of subacromial erosion. Results: The mean preoperative VAS score was 7.6 points, which improved by a significant level of 0.3 at the final follow-up (P <0.001). The UCLA score at the last follow-up was 32.3 points, which was higher than the preoperative average of 15.2 points (P = 0.003). According to the computed tomography (CT) findings, subacromial erosion was found in all cases, and the mean value was 5.0mm, which is 53% of the entire acromion thickness. The AC slope (B=-0.159, P<0.001) and AC-AP distance (B=0.233, P=0.004) were found to have a significant influence on postoperative subacromial erosion. The AC slope showed a negative correlation with the amount of erosion, while the AC-AP distance showed a positive correlation with erosion. onclusion: The study was able to obtain satisfactory clinical and radiological results after locking hook plate fixation for acute ACJ injury. The CT findings revealed that subacromial erosion occurred in all cases, and the mean erosion depth was about 50% of the acromial thickness. If the preoperative AC slope of the unaffected side was more acute and the AC-AP distance was larger, the incidence of subacromial erosion was higher. Level of evidence: Therapeutic Level IV Retrospectively registered study: This study was retrospective in nature, and final approval of informed consent exemption by the institutional review board was obtained (KHUH IRB 2019-04-079)

Download Full-text

Comparison of aortic remodelling after conservative treatment or thoracic endovascular repair in type B dissections

Interactive CardioVascular and Thoracic Surgery ◽

10.1093/icvts/ivz285 ◽

2019 ◽

Vol 30 (3) ◽

pp. 458-464 ◽

Cited By ~ 1

Author(s):

Migdat Mustafi ◽

Mateja Andic ◽

Oana Bartos ◽

Gerd Grözinger ◽

Christian Schlensak ◽

...

Keyword(s):

Growth Rate ◽

Treatment Group ◽

Conservative Treatment ◽

Acute Type ◽

Type B ◽

Descending Aorta ◽

Group A ◽

The Mean ◽

Group B

Abstract OBJECTIVES Our aim was to compare aortic remodelling in type B dissections after thoracic endovascular aortic repair (TEVAR) or conservative treatment. METHODS We conducted a retrospective analysis of computed tomography (CT) data sets at dissection onset and at the last follow-up in a group with conservative (group A) and TEVAR treatment (group B). An additional analysis of the preoperative CT images was performed in patients from group A, who were converted to TEVAR during follow-up. Diameters and lengths of all aortic segments were measured and growth rates were calculated. RESULTS We included 74 patients: 50 patients in group A (follow-up time: 1625 ± 209 days) and 24 patients in group B (follow-up time: 554 ± 129 days). The mean aortic diameter growth rate was significantly higher in group A than in group B in the mid-descending aorta (A: +7 mm/year; B: −4 mm/year; P = 0.003). Length growth difference was only present in the abdominal aortic segment and was more pronounced in group A (+2 vs ±0 mm/year; P = 0.009). The conversion rate from conservative treatment to TEVAR was 36% (n = 18). A false lumen diameter of >22 mm at baseline was associated with a higher rate of conversion (P = 0.036). After conversion, the mean growth rate in the proximal descending and mid-descending aorta decreased from preoperative +11 and +18 mm/year to postoperative −9 and −14 mm/year, respectively (P < 0.001). CONCLUSIONS In acute type B dissections, TEVAR stops aortic enlargement in the thoracic aorta, but promotes distal dilatation compared to the conservative treatment group. After conversion to TEVAR in conservatively pretreated chronic type B dissections, a more pronounced diameter decrease in the descending aorta was observed than in patients treated in the acute phase.

Download Full-text

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

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120905022 ◽

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.

Download Full-text