Acromioclavicular joint injury: Enhanced technique of examination with dynamic maneuver

Peetrons, P; Bédard, Justine

doi:10.1002/jcu.20339

Cited by 29 publications

(17 citation statements)

References 8 publications

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“…Ultrasound and MRI have been described to evaluate lesions of the stabilizing structures of the AC-joint [1,[13][14][15][16]23]. However, these diagnostic tools have not been used to evaluate intraarticular glenohumeral pathology.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of concomitant intraarticular lesions in patients treated operatively for high-grade acromioclavicular joint separations

Pauly

Gerhardt

Haas

et al. 2008

Knee Surg Sports Traumatol Arthrosc

108

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The purpose of this study is to investigate the prevalence of concomitant intraarticular lesions to the glenohumeral joint or to surrounding soft tissue structures with non-randomized prospective case series. High-grade acromioclavicular (AC) joint dislocations result from direct or indirect force impact to the shoulder girdle. Fourty consecutive patients (2 female, 38 male) with high-grade acromioclavicular joint dislocations (Rockwood III: n = 3; IV: n = 3; V: n = 34) who underwent diagnostic arthroscopy at the time of acromioclavicular joint repair were evaluated. Associated pathologic lesions were documented and treated by an all-arthroscopic approach. As a result, traumatic intraarticular lesions were found in 15% (n = 6/40) of cases. Two patients had an isolated partial tear of the subscapularis tendon. One patient had a combined tear of the subscapularis and supraspinatus tendon (PASTA type lesion). Two patients showed a type II SLAP-lesion and one patient had a type VI SLAP-lesion. Arthroscopic treatment included rotator cuff reconstruction in two cases and debridement of the partially torn tendon in one case. Two patients underwent an arthroscopic SLAP-repair and in one patient a debridement of a labral flap tear was performed. Acromioclavicular joint reconstruction was achieved via an open technique using suture anchors in 14 cases and via an all-arthroscopic approach using a double Tight-rope technique in 26 cases. To conclude, in number of cases, high-grade AC-separations may be associated with traumatic concomitant glenohumeral pathologies resulting from the same trauma impact to the shoulder girdle. A combined or an all-arthroscopic approach allows to accurately diagnose and treat associated intraarticular pathologies.

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Section: Discussionmentioning

confidence: 99%

Prevalence of concomitant intraarticular lesions in patients treated operatively for high-grade acromioclavicular joint separations

Pauly

Gerhardt

Haas

et al. 2008

Knee Surg Sports Traumatol Arthrosc

108

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“…Although the role of ultrasound in imaging AC joint injuries remains unclear, a recent study using this modality identified abnormal movements of the injured AC joint with cross-arm adduction which were not identified with plain resting or stress radiographs. 28 …”

Section: Imagingmentioning

confidence: 97%

“…[34][35][36] Highgrade injuries (types IV-VI) are treated surgically. 25,28,30,[37][38][39][40][41][42][43][44] Management of the patient with type III AC separation remains controversial, with success rates in this population ranging from 87% to 96% in both operative and nonoperative treatments. This injury is characterized by complete disruption of both the AC and CC ligaments, without much disruption of the deltoid or trapezial fascia.…”

Section: Traumatic Conditions Of the Acromioclavicular Jointmentioning

confidence: 99%

Acromioclavicular Joint Problems in Athletes and New Methods of Management

Rios¹,

Mazzocca²

2008

Clinics in Sports Medicine

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“…The role of ultrasound in imaging ACJ injuries remains unclear; a recent study using this modality identified abnormal movements of the injured ACJ with cross-arm adduction which were not identified with plain resting or stress radiographs [46].…”

Section: Imagingmentioning

confidence: 98%

Management of the Acromioclavicular Joint Problems

Tetik

2011

Sports Injuries

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The acromioclavicular joint (ACJ) is composed of the distal end of the clavicle and the acromion. Its function is to anchor the clavicle to the scapula and to the shoulder girdle. The subcutaneous location of this joint makes it vulnerable to injury. It is approximately 9% of all the shoulder injuries. The majority of the injuries occur in men with a male to female ratio of approximately 5:1, and patients in their 20s are the most affected age group [53]. Because of the high incidence of these injuries, orthopedists, sports medicine doctors, emergency physicians, and physical therapists should be aware of the management of these injuries [56]. AnatomyThe ACJ is subcutaneous and has little protection by soft tissues. It is composed of the distal end of the clavicle and the acromion and serves to anchor the clavicle to the scapula and the shoulder girdle. This is an inherently unstable articulation. ACJ capsule and the strong coracoclavicular (CC) ligaments, conoid ligament medially and trapezoid ligament laterally, support the joint and provide static stability. The dynamic stabilizers are the trapezius and deltoid muscles. The distal ends of the clavicle and the acromion are lined with hyaline cartilage, and there is a meniscal structure intraarticularly. The role of this meniscus is negligible, and generally it is thought to be degenerated during the fourth decade [56].The clavicular origin of the conoid ligament originates an average of 46 mm medial to the ACJ, and the trapezoid ligament originates 26 mm medial to the ACJ. The conoid is more posterior compared with the trapezoid origin at the mid-portion of the inferior surface of the clavicle [52]. The superior, inferior, and posterior acromioclavicular (AC) ligaments insert an average of 16-20 mm medial to the ACJ on the clavicle. The importance of this anatomic observation is that aggressive distal clavicle excision (DCE) can destabilize the ACJ and lead to symptomatic posterior impingement against the acromion if that ranges were exceeded.

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Acromioclavicular joint injury: Enhanced technique of examination with dynamic maneuver

Cited by 29 publications

References 8 publications

Prevalence of concomitant intraarticular lesions in patients treated operatively for high-grade acromioclavicular joint separations

Prevalence of concomitant intraarticular lesions in patients treated operatively for high-grade acromioclavicular joint separations

Acromioclavicular Joint Problems in Athletes and New Methods of Management

Management of the Acromioclavicular Joint Problems

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