Surgery improves the clinical and radiological outcome in Rockwood type IV dislocations, whereas Rockwood type III dislocations benefit from conservative treatment

Feichtinger, Xaver; Dahm, Falko; Schallmayer, Daniel; Boesmueller, Sandra; Fialka, Christian; Mittermayr, Rainer

doi:10.1007/s00167-020-06423-5

Cited by 5 publications

(9 citation statements)

References 2 publications

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“…Data on conservative therapy attempts for Rockwood grade IV and V injuries are hardly available [ 10 ]. One factor in favor of operative treatment may be a remaining visible protrusion of the clavicle [ 11 , 12 ]. There is a variety of operative treatments but there is no gold standard [ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Operative vs. conservative treatment of AC-Joint Dislocations Rockwood grade ≥ III -An economical and clinical evaluation-

Niehaus,

Schleicher,

Ammann

et al. 2023

Cost Eff Resour Alloc

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Introduction Acromioclavicular joint dislocations (ACD) are one of the most common shoulder injuries. There is no consensus in how to treat higher graded ACD ≥ Rockwood grade III. This study compares operative versus conservative treatment regarding costs and clinical outcome parameters. Materials and Methods This retrospective, consecutive case-control-study includes 14 patients. Seven operatively treated patients were matched, by Rockwood grade, with seven conservatively treated patients. The cost was extracted out of the clinical- and insurance-based cost sheets and furthermore these include the loss of earnings. Clinical examination, demographic data as well as different outcome-questionnaires were recorded. Results There were no significant differences between operative and conservative treated patients for outcome Questionnaires. Of note, there was a significantly higher incidence of tenderness over the AC-joint (p = 0.0038) postoperatively. As expected, economical evaluation showed various findings in favor of the conservative treatment. The costs for medical services (11012.39vs.1163.81USD; p = 0.0061), days of hospitalization (3.3vs.0days; p < 0.0001); total cost for medical treatment (30262.17 vs. 7833.82 USD; p = 0.0358) were significantly higher in the operative group. Conclusion Even with a limited case number and a retrospective study design almost all clinical results were equal in both groups. Operative therapy of higher graded ACDs (Rockwood > III) compared to conservative is economically inefficient. Under consideration of clinical comparable results, indications for operative treatment should be set very carefully.

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Section: Introductionmentioning

confidence: 99%

Operative vs. conservative treatment of AC-Joint Dislocations Rockwood grade ≥ III -An economical and clinical evaluation-

Niehaus,

Schleicher,

Ammann

et al. 2023

Cost Eff Resour Alloc

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“…While the CC ligament may portend vertical stability, isolated reconstruction of the CC ligament is subjected to greater horizontal forces without the stress shielding presence of AC ligaments. 25,26 In their biomechanical study, Gonzalez-Lomas et al 16 highlights the importance of the AC ligaments as horizontal stabilizers, reporting a 50% decrease in horizontal translation when both AC and CC ligaments are repaired compared with free tissue isolated CC ligament reconstruction. Walters et al 27 further investigated the clinical importance of AC ligament reconstruction in their matched cohort study.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Failed Coracoclavicular Ligament Reconstructions: Primary Acromioclavicular Ligament and Capsular Reconstruction and Revision Coracoclavicular Ligament Reconstruction

Jildeh

Peebles²,

Brown³

et al. 2022

Arthroscopy Techniques

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“…5 En este caso presentamos una inestabilidad crónica, con aporte biológico y técnica anatómica, más revisión de la literatura en cuanto al manejo. 6…”

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Inestabilidad acromioclavicular crónica tratada mediante reconstrucción anatómica de los ligamentos coracoclaviculares: plastia tipo Mazzocca

Fuentes¹,

Encarnación²

2022

Ortho-Tips

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Los ligamentos coracoclaviculares representan un vínculo entre la clavícula y la escápula, siendo el principal elemento suspensorio de la extremidad superior.Estudios recientes dictaminan que el manejo conservador condicionará alteraciones de la musculatura de la cintura escapulohumeral, clínicamente se verá reflejado en dolor. [1][2][3] Las luxaciones crónicas son todas aquellas que tienen más de tres semanas de evolución y su enfoque terapéutico es muy diferente a las lesiones agudas; en la patología aguda se acepta que tanto los ligamentos acromioclaviculares como los coracoacromiales (conoide y trapezoide) aún tienen la capacidad de cicatrizar, por lo que la reparación es aceptada. 4 El manejo quirúrgico está indicado en las luxaciones grado III con datos de discinesia escapular y solapamiento del tercio distal de la clavícula, mismo que se valora en la proyección de Alexander, y las luxaciones grado V.

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Surgery improves the clinical and radiological outcome in Rockwood type IV dislocations, whereas Rockwood type III dislocations benefit from conservative treatment

Cited by 5 publications

References 2 publications

Operative vs. conservative treatment of AC-Joint Dislocations Rockwood grade ≥ III -An economical and clinical evaluation-

Operative vs. conservative treatment of AC-Joint Dislocations Rockwood grade ≥ III -An economical and clinical evaluation-

Treatment of Failed Coracoclavicular Ligament Reconstructions: Primary Acromioclavicular Ligament and Capsular Reconstruction and Revision Coracoclavicular Ligament Reconstruction

Inestabilidad acromioclavicular crónica tratada mediante reconstrucción anatómica de los ligamentos coracoclaviculares: plastia tipo Mazzocca

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