Inestabilidad de la cintura escapular secundario a fractura de acromion asociada a luxación acromioclavicular. A propósito de un caso. Hospital Luis Vernaza

Introduction The superior suspensory complex (SSSC) described by Goss, is a ring composed of the glenoid, the coracoid process, the coracoclavicular ligaments, the distal clavicle, the acromioclavicular joint and the acromial process. A double disruption of the upper suspensory complex of the shoulder produces an instability between the complex of the scapular waist and the axial skeleton, called "floating shoulder". Objective. It establishes the importance of the study of cases concerning the instability of the shoulder girdle Materials and methods Here is shown the case of a patient with double disruption of the SSSC, Results for displaced fracture of acromion associated with acromioclavicular dislocation, treated surgically with satisfactory results. Discussion Although surgical indications have been reported, the fixation techniques of these fractures is limited. Conclusions We present this case that is not frequent in our professional practice.

Download Full-text

Displaced Fracture of the Coracoid Process Associated With Acromioclavicular Dislocation: A Two-Bird–One-Stone Solution

Journal of Trauma and Acute Care Surgery ◽

10.1097/ta.0b013e3181ac8ef1 ◽

2009 ◽

Vol 67 (2) ◽

pp. 403-405 ◽

Cited By ~ 15

Author(s):

Kyung-Cheon Kim ◽

Kwang-Jin Rhee ◽

Hyun-Dae Shin ◽

Dong-Kyu Kim ◽

Han-Sol Shin

Keyword(s):

Coracoid Process ◽

Acromioclavicular Dislocation ◽

Displaced Fracture

Download Full-text

A study of coracoclavicular joint in South Indian population

National Journal of Clinical Anatomy ◽

10.1055/s-0039-3401670 ◽

2012 ◽

Vol 01 (02) ◽

pp. 081-085

Author(s):

Umapathy Sembian ◽

Muhil M. ◽

Nalina Kumari S D.

Keyword(s):

Indian Population ◽

Shoulder Girdle ◽

Coracoid Process ◽

South Indian Population ◽

Coracoclavicular Ligaments ◽

Articular Facet ◽

First Rib ◽

South Indian ◽

Superior Surface ◽

Coracoclavicular Joint

Abstract Background: Movements taking place in the shoulder girdle is a result of complex coordinated movements between the glenohumeral, acromio clavicular, sternoclavicular and scapulothoracic articulations. Clavicle is connected with the first rib by the costoclavicular ligament apart from the sternum and scapula through sternoclavicular and coracoclavicular ligaments. Sometimes the area of attachment of these ligaments on the clavicle, first rib and scapula show faceted apophysis suggesting the presence of additional diarthrodial articulation. The incidence of Coraco–Clavicular (CCJ) joint in various populations is estimated to be ranging from 0.8% - 9.8%. Aim : The aim of our present study is to ascertain the prevalence of Coraco-Clavicular joint (CCJ) in South Indian population. Materials and methods : The present study was carried out on fifty cadavers embalmed with 10% formalin. Meticulous care was taken to include only cadavers from South Indian population. Cadavers exhibiting obscuring pathologies were excluded from the study. The dissections were carried out in all the limbs to note the presence of a diarthrotic coracoclavicular joint which is represented by the presence of an articular facet on the conoid tubercle of the clavicle & the superior surface of the coracoid process of the scapula. Results : In our study we came across a single cadaver having the coracoclavicular joint on the left side unilaterally. Conclusion : The coracoclavicular joint though a rare entity should be borne in mind as a differential diagnosis for thoracic outlet syndrome or costoclavicular syndrome and in general for shoulder pain. The present study has revealed the presence of CCJ in our population and it constitutes to only 2%.

Download Full-text

Posterior wall acetabular fractures: update on surgical indications, fixation techniques and outcome measurements

Current Orthopaedic Practice ◽

10.1097/bco.0b013e3181b3a5f2 ◽

2009 ◽

Vol 20 (5) ◽

pp. 511-521 ◽

Cited By ~ 1

Author(s):

Greg M Osgood

Keyword(s):

Posterior Wall ◽

Acetabular Fractures ◽

Surgical Indications ◽

Outcome Measurements ◽

Fixation Techniques

Download Full-text

Kirschner Pin Migration Associated with the Sliding Genioplasty

The American Journal of Cosmetic Surgery ◽

10.1177/074880689301000104 ◽

1993 ◽

Vol 10 (1) ◽

pp. 15-19

Author(s):

David J. Gingrass

Keyword(s):

Retrospective Study ◽

Bone Plates ◽

Surgical Indications ◽

Common Procedure ◽

Vertical Movements ◽

Medical College ◽

Advantages And Disadvantages ◽

Fixation Techniques ◽

The Mean

The sliding genioplasty for cosmetic augmentation of microgenia is a common procedure performed by maxillofacial and cosmetic surgeons. There are multiple designs for this osteotomy, and multiple fixation techniques proposed, among which include wires, screws, bone plates, and pins. Likewise, there are many advantages and disadvantages to each of the designs and the fixation techniques that will be utilized according to the surgical indications and the surgeon's preference. A techique used at the Medical College of Wisconsin in Milwaukee involves fixation of the osteotomy segments with Kirschner pins placed at multiple divergent angles. This technique allows for placement of the free segments in virtually any location, and provides for a type of rigid stabilization, particularly in large anterior and vertical movements. One criticism that has been suggested with the use of Kirschner pins is the possibility of migration. This retrospective study evaluates 13 patients who underwent augmentation genioplasty, rigidly fixated with Kirschner pins. Twenty-eight total Kirschner pins were placed, with one being removed. The mean postoperative follow-up was 32 months, and the average number of pins placed was 2.15 per patient. It would appear then, from this study, that migration of Kirschner pins when used with the sliding genioplasty, is not a significant postoperative concern.

Download Full-text

The floating flail chest: Acute management of an injury combination of the floating shoulder and flail chest

Journal of Orthopaedics Trauma and Rehabilitation ◽

10.1177/2210491719899076 ◽

2020 ◽

Vol 27 (1) ◽

pp. 10-15

Author(s):

Brian P Cunningham ◽

Liam Bosch ◽

David Swanson ◽

Ryan McLemore ◽

Anthony S Rhorer ◽

...

Keyword(s):

Operative Treatment ◽

Retrospective Cohort ◽

Flail Chest ◽

Shoulder Girdle ◽

Hospital Length ◽

Injury Pattern ◽

Hospital Length Of Stay ◽

Trauma Centers ◽

Floating Shoulder ◽

Level I

Background/purpose: The combination of ipsilateral floating shoulder and flail chest is a unique injury pattern that has not been previously described in the literature. We termed the injury pattern floating flail chest (FFC). The purpose of this study was to evaluate the effect of operative treatment of the shoulder girdle component to overall hospital length of stay (LOS). Methods: Forty-one patients were enrolled between two level I trauma centers identifying with a combination ipsilateral floating shoulder and flail chest injury, 23 treated with operative stabilization and 18 treated non-operatively. This retrospective cohort study evaluated the overall LOS and intensive care unit (ICU) days. Results: The operative group had decreased overall LOS (10.1 vs. 19.8 days, p = 0.02) and decreased ICU days (3.4 vs. 10.3, p = 0.04). Conclusion: This study describes a unique injury pattern that combines the floating shoulder and flail chest, FFC. Our study suggests that operative treatment of the shoulder girdle may decrease both overall LOS and ICU days in patients with FFC.

Download Full-text