Distal Clavicle Physeal Separation Mimicking an Acromioclavicular Joint Separation

Aebischer, Andrea S; Sarai, Harminder; Wall, Christopher J.

doi:10.2106/jbjs.cc.20.00556

Cited by 1 publication

(2 citation statements)

References 16 publications

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“…Although concrete management guidelines are lacking, most of the studies in this review chose operative management in cases with soft tissue impingement, buttonholing of the clavicle in the trapezius, excessive displacement of the clavicle and presence of concomitant injuries like coracoid fractures and clavicle fractures [7,16,18,19,22,24,28]. On the other hand, conservative management was suggested for minimally displaced dislocations and voluntary atraumatic dislocation due to their chronic nature and minimal symptoms [26,27].…”

Section: Discussionmentioning

confidence: 99%

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Acromioclavicular Joint Lesions in Adolescents—A Systematic Review and Treatment Guidelines

Wahal,

Kendirci,

Abondano

et al. 2023

JCM

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True acromioclavicular joint (ACJ) injuries are rare in children and adolescents due to the strength of ligaments in this age group. However, a standardized management guideline for these injuries is currently lacking in the literature. This systematic review aims to provide an organized overview of associated injuries and propose a management algorithm for pediatric ACJ injuries. Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a systematic review was conducted. Two independent observers searched PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and Scopus databases for ACJ injuries in children and adolescents. The extracted data were analyzed (due to the limited number of publications and inhomogeneity of data, no formal statistical analysis was conducted), and cases were categorized based on injury frequency and pattern, leading to the formulation of a treatment algorithm. The risk of bias was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklist. A total of 77 articles were identified, and 16 articles (4 case series and 12 case reports) met the inclusion criteria. This study included 37 cases in 36 patients (32 males, 4 females) with a mean age of 13 years (9–17 years). Six injury categories were described. Surgical management was performed in 27 ACJ injuries (25 open, 2 arthroscopic). Various surgical implants were used including K wires, polydioxanone sutures (PDS), screws, hook plates, suture anchors, and suture button devices. Most cases achieved good to excellent outcomes, except for one case of voluntary atraumatic dislocation of the ACJ. This systematic review provides the first comprehensive analysis of ACJ injury management in adolescents with open physis. It categorizes injury patterns and presents a treatment algorithm to enhance the understanding of these injuries. The review’s findings contribute valuable insights for clinicians dealing with pediatric ACJ injuries.

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Section: Discussionmentioning

confidence: 99%

“…A total of 14 cases were reported, out of which 12 were operated (Table 1). Operative intervention was chosen in 12 cases due to significant displacement or soft tissue impingement [15,[17][18][19][20]24].…”

Section: Categorization Of the Injuriesmentioning

confidence: 99%