scholarly journals Ipsilateral midshaft clavicle fracture and acromioclavicular joint dislocation: a review of literature and evidence-based diagnosis guidelines

2020 ◽  
Author(s):  
Rongguang Ao ◽  
Zhen Jian ◽  
Jinhong Chen ◽  
Dejian Li ◽  
Xu Zhang ◽  
...  
Keyword(s):  
Clavicle Fracture ◽  
High Energy ◽  
Shoulder Function ◽  
Acromioclavicular Joint Dislocation ◽  
Evidence Based ◽  
Ac Joint ◽  
Level Of Evidence ◽  
Joint Dislocation ◽  
Type Iv ◽  
Ac Joint Dislocation

Abstract Background: Ipsilateral midshaft clavicle fracture and AC joint dislocation are rare, with very few cases reported. Once the AC joint dislocation were missed diagnosis, the shoulder function may be affected and medical dispute was easy to occur. The aim of this study was to gather data relating to ipsilateral midshaft clavicle fracture and AC joint dislocation to develop evidence-based diagnosis guidelines as none are currently available.Methods: A study was conducted of the PubMed and Google Scholar databases to identify cases of ipsilateral midshaft clavicle fracture and AC joint dislocation. Data collected about each case included age and gender of the patient, mechanism of injury, fracture and dislocation classification. The authors report 2 additional ipsilateral midshaft clavicle fracture and AC joint dislocation cases.Results: 21 cases were identified for inclusion in this research, 19 from the literature and 2 reported by the authors. All the patients were injured by high energy trauma. For the midshaft fracture, 16/21 (76.2%) patients belonged to Type A classification, and 5/21 (23.8%) patients belonged to Type B classification. For AC joint dislocation, 11/21 (47.6%) patients belonged to Type IV classification, 4/21 (19.0%) patients belonged to Type VI classification, 5/21 (23.8%) patients belonged to Type III classification and 1/21 (4.7%) patients belonged to Type V classification.Conclusions: There are limited data available about the diagnosis of ipsilateral midshaft clavicle fracture and AC joint dislocation. From the cases reviewed, we find that simple midshaft clavicle caused by high energy injuries may be associated with ipsilateral AC joint dislocation. Physical examination, careful observation of preoperative X-ray and fluoroscopy including the AC joint during operation were key to diagnose the injury. Level of Evidence Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

scholarly journals Simultaneous Injury of Mid-shaft Clavicle Fracture and Type IV Acromioclavicular Joint Dislocation

2020 ◽  
Vol 7 (1) ◽  
pp. 35-40
Author(s):  
Amir Sobhani Eraghi ◽  
◽  
Mehdi Moghtadaei ◽  
Iman Azizpour ◽  
Mikaiel Hajializade ◽  
...  
Keyword(s):  
Treatment Options ◽  
Clavicle Fracture ◽  
Hybrid Approach ◽  
Management Approach ◽  
Acromioclavicular Joint Dislocation ◽  
Ac Joint ◽  
Joint Dislocation ◽  
Type Iv ◽  
Ac Joint Dislocation ◽  
Surgical Fixation

Background: Combined injuries of Mid-shaft clavicle fracture and Acromioclavicular (AC) joint dislocation are rare, and only a few cases have been reported. Several treatment options including surgical, conservative and hybrid approach have been described. Yet, there is no consensus regarding the optimal management approach for this injury. Objectives: Here we reported a case of Mid-shaft clavicle fracture with associated type IV AC joint dislocation in a 29-year-old male following a cycling accident. Methods: Both parts of the injury were fixed surgically. Meanwhile, the patient did not follow the postoperative protocol and started the heavy sports activities one month after the surgery. Results: The patient showed up 6weeks after the surgery with slightly uncorrected AC joint. However, he was satisfied with the results and accordingly no intervention was done for the correction of the AC joint. Conclusion: Our case reveals the importance of adherence to the postoperative protocol in this combined and challenging injury and we recommend surgical fixation for such injury.

scholarly journals Fifteen-degree clavicular hook plate achieves better clinical outcomes in the treatment of acromioclavicular joint dislocation

2018 ◽  
Vol 46 (11) ◽  
pp. 4547-4559 ◽  
Author(s):  
Guanghui Li ◽  
Tuoen Liu ◽  
Xianfang Shao ◽  
Zhijun Liu ◽  
Jianhui Duan ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Postoperative Recovery ◽  
Hook Plate ◽  
Acromioclavicular Joint Dislocation ◽  
Ac Joint ◽  
Level Of Evidence ◽  
Joint Dislocation ◽  
Ac Joint Dislocation ◽  
Clavicular Hook Plate ◽  
Retrospective Comparative Study

Objective Clavicular hook plate application is one of the most commonly used treatment methods for acromioclavicular (AC) joint dislocation, although it may cause multiple postoperative complications. We modified the regularly used 0° hook plate to 15° and compared the clinical outcomes of these two hook plates for treatment of AC joint dislocation. Methods Forty-three patients with acute AC joint dislocation were randomly enrolled (0° hook plate, 20 patients; 15° hook plate, 23 patients). The American Shoulder and Elbow Surgeons (ASES) and visual analog scale for pain (VASP) scores were evaluated preoperatively and at 3 days and 1, 2, 3, and 6 months postoperatively and compared between the two groups. Results Compared with the preoperative scores, the 6-month postoperative ASES score gradually increased but the VASP score decreased in both groups. Furthermore, the ASES and VASP scores were significantly different between the two groups at every postoperative time point. Conclusion The 15° hook plate is superior to the 0° hook plate in reducing shoulder pain and improving postoperative recovery in the treatment of AC joint dislocation. Level of evidence Level III; Treatment study (retrospective comparative study).

scholarly journals Treatment of chronic acromioclavicular joint dislocation in a paraplegic patient with the Weaver-Dunn procedure and a hook-plate

2016 ◽  
Vol 8 (2) ◽  
Author(s):  
Holger Godry ◽  
Mustafa Citak ◽  
Matthias Königshausen ◽  
Thomas A. Schildhauer ◽  
Dominik Seybold
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Weight Bearing ◽  
Full Range ◽  
Hook Plate ◽  
Acromioclavicular Joint Dislocation ◽  
Ac Joint ◽  
Joint Dislocation ◽  
Ac Joint Dislocation ◽  
Cord Injury

Abstract In case of patients with spinal cord injury and concomitant acromioclavicular (AC) jointdislocation the treatment is challenging, as in this special patient group the function of the shoulder joint is critical because patients depend on the upper limb for mobilization and wheelchair-locomotion. Therefore the goal of this study was to examine, if the treatment of chronic AC-joint dislocation using the Weaver- Dunn procedure augmented with a hook-plate in patients with a spinal cord injury makes early postoperative wheelchair mobilization and the wheelchair transfer with full weightbearing possible. In this case the Weaver- Dunn procedure with an additive hook-plate was performed in a 34-year-old male patient with a complete paraplegia and a posttraumatic chronic AC-joint dislocation. The patient was allowed to perform his wheelchair transfers with full weight bearing on the first postoperative day. The removal of the hook-plate was performed four months after implantation. At the time of follow-up the patient could use his operated shoulder with full range of motion without restrictions in his activities of daily living or his wheel-chair transfers.

scholarly journals Clinical and Radiological Results of Hook Plate Fixation in Acute Acromioclavicular Joint Dislocations and Distal Clavicle Fractures

2018 ◽  
Vol 21 (2) ◽  
pp. 95-100
Author(s):  
Joo Han Oh ◽  
Seunggi Min ◽  
Jae Wook Jung ◽  
Hee June Kim ◽  
Jae Yoon Kim ◽  
...  
Keyword(s):  
Plate Fixation ◽  
Clavicle Fracture ◽  
Hook Plate ◽  
Distal Clavicle ◽  
Ac Joint ◽  
Joint Dislocation ◽  
Group I ◽  
Joint Dislocations ◽  
Ac Joint Dislocation ◽  
Group Ii

BACKGROUND: The purpose of this study was to evaluate the clinical outcomes and complications of hook plate fixation in acromioclavicular (AC) joint dislocations and distal clavicle fractures.METHODS: We retrospectively reviewed a series of 60 consecutive patients with hook plate fixation for AC joint dislocation (group I) and distal clavicle fracture (group II). Groups I and II had 39 and 21 patients, respectively. Clinical results were evaluated using the pain visual analogue scale (VAS), simple shoulder test, and Constant-Murley scores. In addition, subacromial erosion and stiffness were evaluated as complications.RESULTS: At the removal, the pain VAS was 2.69 ± 1.30 and 4.10 ± 2.14 in groups I and II, respectively, which were significantly different (p=0.003). The simple shoulder test score was 9.59 ± 1.60 and 7.81 ± 2.67 in groups I and II, respectively, which were also significantly different (p=0.002). Subacromial erosion was significantly more frequent in group II (14/21 patients, 66.7%) than in group I (15/39 patients, 38.5%) (p=0.037), and stiffness was also higher in group II (17/21 patients, 81.0%) than in group I (22/39 patients, 56.4%), but it was not significant.CONCLUSIONS: Hook plate fixation showed good clinical and functional results for the treatment of acute unstable AC joint dislocation and distal clavicle fracture. But, in distal clavicle fractures, there are more subacromial erosion and stiffness compare with acute unstable AC joint dislocation.

Acromion Fracture and Acromioclavicular Joint Dislocation: A Case Report

2020 ◽  
Author(s):  
Mohammad Zarei ◽  
Saied Besharaty ◽  
Alireza Moharrami ◽  
Rasul Ghaedi
Keyword(s):  
Acromioclavicular Joint Dislocation ◽  
Early Recovery ◽  
Ac Joint ◽  
Early Management ◽  
Case Presentation ◽  
Joint Dislocation ◽  
Ac Joint Dislocation ◽  
Acromion Fracture ◽  
Acromial Fracture ◽  
Clavicle Fractures

Background: Acromion fractures are rare injuries that may occur because of shoulder trauma. This may be associated with distal clavicle fractures, which can be an indication for surgery. There are several methods, which are used for fixation of this type of fractures. Case Presentation: In this paper, we presented a 34 years old man with acromion fracture in contribution with acromioclavicular (AC) joint dislocation. We applied a new method for fixation of this fracture. The fracture was fixed by 2 screws and AC Joint was fixed by a 4-hole hook plate. Conclusions: It is important to be aware of acromial fracture to not miss them and also for early management, so that early recovery and satisfactory results can be gained

scholarly journals Treatment of acute high-grade acromioclavicular joint dislocation

2020 ◽  
Vol 23 (3) ◽  
pp. 159-165
Author(s):  
Jeung Yeol Jeong ◽  
Yong-Min Chun
Keyword(s):  
Standard Procedure ◽  
High Energy ◽  
Acromioclavicular Joint Dislocation ◽  
High Grade ◽  
Shoulder Injuries ◽  
Ac Joint ◽  
Joint Injury ◽  
Joint Dislocation ◽  
Treatment Type ◽  
Joint Dislocations

Acromioclavicular (AC) joint dislocations account for about 9% of shoulder injuries. Among them, acute high-grade injury following high-energy trauma accounts for a large proportion of patients requiring surgical treatment. However, there is no gold standard procedure for operative treatment of acute high-grade AC joint injury, and several different procedures have been used for this purpose in clinical practice. This review article summarizes the most recent and relevant surgical options for acute high-grade AC joint dislocation patients and the outcomes of each treatment type.

scholarly journals A Posteriorly Displaced Distal Metaphyseal Clavicular Fracture (Type IV AC Joint Dislocation-Like) in Children: A Case Report and Literature Review Study

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Ahmed Kotb ◽  
Taylor Yong ◽  
Amr Abdelgawad
Keyword(s):  
Literature Review ◽  
Pediatric Patients ◽  
Trapezius Muscle ◽  
Ac Joint ◽  
Unique Type ◽  
Joint Dislocation ◽  
Recommended Treatment ◽  
Type Iv ◽  
Ac Joint Dislocation ◽  
Salter Harris

Fractures of the lateral end of the clavicle are common in pediatric patients; most of these fractures occur at the physeal level representing Salter Harris injuries. The vast majority of fractures of the lateral end of the clavicle are managed nonoperatively. In this report, we describe a unique type of fracture of the distal end of the clavicle in the pediatric patients in which the fracture occurs in the metaphyseal lateral clavicle with the proximal edge of the fracture displaced posteriorly through the trapezius muscle causing obvious deformity. It is similar in pathology to type IV AC joint dislocation. In this study we report this injury in eleven-year-old boy. Literature review showed that similar injuries were described before three times (two of them in pediatric patients). Due to the significant clinical deformity of this category with entrapment of the bone through the trapezius muscle, reduction (open or closed) of the fracture is the recommended treatment.

scholarly journals A retrospective comparative study of arthroscopic fixation for acute acromioclavicular joint dislocation: coracoid sling technique versus single-tunnel technique

2021 ◽  
Author(s):  
Liangquan Peng ◽  
Yizi Zheng ◽  
Greg Zhang ◽  
Zhenhan Deng
Keyword(s):  
Clinical Outcomes ◽  
Acromioclavicular Joint Dislocation ◽  
Return To Sports ◽  
Ac Joint ◽  
Joint Dislocation ◽  
Ac Joint Dislocation ◽  
Significant Difference ◽  
Tunnel Technique ◽  
Arthroscopic Fixation

Abstract Background Arthroscopic fixation in acute acromioclavicular (AC) joint dislocation has become more popular and shown good clinical outcomes. This study aims to evaluate and compare the efficacy of single-tunnel technique (SST) and coracoid sling technique (CST) for the treatment of acute AC joint dislocation in order to provide more suitable treatment options and clinical recommendations for orthopaedic surgeons. Methods We retrospectively reviewed the charts of patients with acute Rockwood type IV and V AC joint dislocation who had undergone arthroscopic fixation procedure with SST or CST fixation between June 2009 and June 2018. A total of 90 consecutive patients identified from chart review were picked and divided into SST and CST groups, with 45 members in each group. The Visual Analog Scale (VAS) pain score, Constant shoulder functionality score, Karlsson AC joint score, the time of return to sports and activity, and plain radiographs of the affected shoulder at different time points of follow-up were all recorded for a minimum of 2 years postoperatively. Results The majority of the patients in both groups recovered to their preoperative activity levels with few complications. The average postoperative AC and coracoclavicular (CC) distances were significantly narrower than preoperative measurements in both groups, and no significant difference was observed between the two groups at 2 years post-op. The CST group had reduced operative time, shorter time of recovery of shoulder movements, higher Constant functionality scores and Karlsson AC joint scores, and fewer complications than the STT group at the last clinical follow-up. Conclusions CST technique achieved superior clinical outcomes with fewer complications compared to the traditional STT technique in arthroscopic treatment of acute AC joint dislocation. This technique could be considered as a reliable method for AC joint reconstruction.

scholarly journals Missed type IV AC joint dislocation: A case report

Injury Extra ◽  
2006 ◽  
Vol 37 (8) ◽  
pp. 283-285 ◽  
Author(s):  
Angharad Lee ◽  
Quamar Bismil ◽  
Richard Allom ◽  
Jeremy Pike
Keyword(s):  
Case Report ◽  
Ac Joint ◽  
Joint Dislocation ◽  
Type Iv ◽  
Ac Joint Dislocation

scholarly journals Clinical and Radiological Outcomes of Modified Phemister Operation with Coracoclavicular Ligament Augmentation Using Suture Anchor for Acute Acromioclavicular Joint Dislocation

2019 ◽  
Vol 22 (2) ◽  
pp. 93-99
Author(s):  
Nam Su Cho ◽  
Sung Ju Bae ◽  
Joong Won Lee ◽  
Jeung Hwan Seo ◽  
Yong Girl Rhee
Keyword(s):  
Suture Anchor ◽  
External Rotation ◽  
Constant Score ◽  
Acromioclavicular Joint Dislocation ◽  
Ac Joint ◽  
Joint Dislocation ◽  
Ligament Augmentation ◽  
Ac Joint Dislocation ◽  
The Mean

Background: Modified Phemister operation has been widely used for the treatment of acute acromioclavicular (AC) joint dislocation. Additionally, the use of suture anchor for coracoclavicular (CC) fixation has been reported to provide CC stability. This study was conducted to evaluate the clinical and radiological results of a modified Phemister operation with CC ligament augmentation using suture anchor for acute AC joint dislocation.Methods: Seventy-four patients underwent the modified Phemister operation with CC ligament augmentation using suture anchor for acute AC joint dislocation and were followed-up for an average of 12.3 months. The visual analogue scale (VAS), range of motion, Constant score, and Korean shoulder scoring system (KSS) were used for clinical assessment. Acromioclavicular interval (ACI), coracoclavicular distance (CCD), and acromioclavicular distance (ACD) were obtained to evaluate the radiological assessments.Results: At the last follow-up, the mean VAS Score was 1.7 points, the mean joint range of the forward flexion was 164.6°, external rotation at the side was 61.2°, and internal rotation to the posterior was a level of T12. The mean Constant score and the mean KSS was 82.7 points and 84.2 points, respectively. At the mean ACI, CCD, and ACD, significant differences were found preoperatively and at the last follow-up. When the ACI, CCD, and ACD were compared with the contralateral unaffected shoulder at the last follow-up, the affected shoulders had significantly higher values.Conclusions: The modified Phemister operation with CC ligament augmentation using suture anchor is clinically and radiologically effective at acute AC joint dislocation.

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