Reconstruction of displaced acromio-clavicular joint dislocations using a triple suture-cerclage: description of a safe and efficient surgical techniqueReportar como inadecuado




Reconstruction of displaced acromio-clavicular joint dislocations using a triple suture-cerclage: description of a safe and efficient surgical technique - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Patient Safety in Surgery

, 6:25

First Online: 25 October 2012Received: 02 August 2012Accepted: 19 October 2012

Abstract

PurposeIn this retrospective study we investigated the clinical and radiological outcome after operative treatment of acute Rockwood III-V injuries of the AC-joint using two acromioclavicular AC cerclages and one coracoclavicular CC cerclage with resorbable sutures.

MethodsBetween 2007 and 2009 a total of 39 patients fit the inclusion criteria after operative treatment of acute AC joint dislocation. All patients underwent open reduction and anatomic reconstruction of the AC and CC-ligaments using PDS® sutures Polydioxane, Ethicon, Norderstedt, Germany. Thirty-three patients could be investigated at a mean follow up of 32±9 months range 24–56 months.

ResultsThe mean Constant score was 94.3±7.1 range 73–100 with an age and gender correlated score of 104.2%±6.9 88-123%. The DASH score mean 3.46±6.6 points, the ASES score 94.6±9.7points and the Visual Analogue Scale mean 0.5±0,6 revealed a good to excellent clinical outcome. The difference in the coracoclavicular distance compared to the contralateral side was <5 mm for 28 patients, between 5-10 mm for 4 patients, and more than 10 mm for another patient. In the axial view, the anterior border of the clavicle was within 1 cm ventral-dorsal direction of the anterior rim of the acromion in 28 patients 85%. Re-dislocations occured in three patients 9%.

ConclusionOpen AC joint reconstruction using AC and CC PDS cerclages provides good to excellent clinical results in the majority of cases. However, radiographically, the CC distance increased significantly at final follow up, but neither the amount of re-dislocation nor calcifications of the CC ligaments or osteoarthritis of the AC joint had significant influence on the outcome.

Level of evidenceCase series, Level IV

KeywordsAcromioclavicular joint Dislocation Rockwood Cerclage Electronic supplementary materialThe online version of this article doi:10.1186-1754-9493-6-25 contains supplementary material, which is available to authorized users.

Gunther H Sandmann, Frank Martetschläger contributed equally to this work.

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Autor: Gunther H Sandmann - Frank Martetschläger - Lisa Mey - Tobias M Kraus - Arne Buchholz - Philipp Ahrens - Ulrich Stöckle

Fuente: https://link.springer.com/article/10.1186/1754-9493-6-25







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