Local Swelling and Redness Associated with Supraclavicular Nerve Injury

Supraclavicular nerves are at risk in operative procedures when surgical incisions are placed over the clavicle. This report describes a 50-year-old man who developed local swelling and redness of the supraclavicular region after undergoing Weaver-Dunn reconstruction of the coracoclavicular ligament. ENMG was consistent with supraclavicular nerve injury. Since the symptoms may mimic infection, the awareness of this complication will aid the clinician to avoid unnecessary use of antimicrobials.

Biomechanical Study on the Treatment of Acromioclavicular Joint Dislocation by Coracoclavicular Ligament Reconstruction With a Novel EndoButton Plate Combined With Suture Anchor

Purpose This study aimed to assess the biomechanical stability of a novel internal fixation system of EndoButton plate combined with suture anchor in treating acromioclavicular joint dislocation in the cadaveric specimens. In addition, it provides a new method for the clinical treatment of acromioclavicular joint dislocation. Methods Twelve complete shoulder joint specimens were randomly divided into groups A, B, C, and D (n = 3). Firstly, a quasi-static non-destructive circulation experiment was carried out of coracoclavicular ligament until its function failed. Four different internal fixation materials were used to reduce and fix the acromioclavicular joint. Group A was treated with 3.5 mm clavicular hook locking compression plates, Group B with 5 mm suture anchor Group C with 10 mm Endo-button plate, and Group D with a novel combination of 5 mm suture anchor and 10 mm Endo-button plate. Fluoroscopy was performed to undertake the X-ray of the restored acromioclavicular joint, to evaluate the internal fixation position and acromioclavicular joint reduction. Finally, the shoulder joint was fixed firmly on an electronic universal testing machine (100KN) with a self-made stationary fixture, to conduct a destructive static tensile mechanical test of each specimen vertically at a 100 mm/min load speed. The stress-deformation curve was recorded using a computer connected with the universal mechanical testing machine, and the failure strength and reasons for internal fixation were also recorded. Results The average load-to-failure of the coracoclavicular ligament in groups A, B, C, and D was 373.4 ±0.57 N, 373.6 ±0.62 N, 374.4 ±0.68 N, and 373.9 ±0.15 N, respectively (P>0.05). After internal fixation failure, Group A showed two specimens with clavicular fracture, and one with acromial fracture, with an average load-to-failure of 409.8 ±2.92 N. Group B and D showed three specimens with prolapse of anchor, with average load-to-failure of 293.5 ±4.10 N and 374.2 ±0.40 N, respectively. Group C showed three specimens with basilar coracoid fracture, with average load-to-failure of 373.2 ±2.35 N. Statistical differences existed in the biomechanical load of internal fixation failure among the four groups. Group D was statistically different from Group A and Group B, but not Group C. Conclusion The newly designed EndoButton plate combined with suture anchor for coracoclavicular ligament reconstruction was found to boast simple operation and has high feasibility. Thus it was found effective in the reduction of acromioclavicular joint and treatment of acromioclavicular joint dislocation and fitted the biomechanical characteristics of the acromioclavicular joint.

Clinical study on treatment of TOSSY type III acromioclavicular joint dislocation with clavicular hook plate combined with coracoclavicular ligament repair

Objective: To explore the treatment of TOSSY type III acromioclavicular joint dislocation with clavicular hook plate combined with coracoclavicular ligament repair and its clinical effect.Methods: 80 patients with TOSSY type III acromioclavicular joint dislocation who were admitted to our hospital from January 2014 to January 2019 were selected. They were randomly divided into the control group (n = 39, treated with clavicular hook plate) and the observation group (n = 41, treated with clavicular hook plate combined with coracoclavicular ligament repair) by the random number table method. The clinical efficacy in 12 months after operation, related clinical indicators, 12-month postoperative recovery and postoperative complications were compared between the two groups.Results: The excellent and good rate was 92.68% (38/41) in 12 months after operation in the observation group, which was higher than that (76.92%, 30/39) in the control group (p < .05). There were no significant differences in the duration of surgery, intraoperative blood loss and HLOS between the observation group and the control group (p > .05). In 12 months after operation, abduction activity and forward flexion activity of the observation group were higher than those of the control group, and visual analogue score (VAS) was lower than that of the control group (p < .05). The incidence of complications in the observation group was slightly lower than that in the control group, but there was no statistically significant difference between the two groups (p > .05).Conclusions: For TOSSY type III acromioclavicular joint dislocation, clavicular hook plate combined with coracoclavicular ligament repair has a good clinical efficacy. It can improve shoulder joint function, alleviate shoulder pain and have fewer complications. It can provide a reference for clinical treatment of this type of acromioclavicular joint dislocation.