Via de acesso cirúrgico posterossuperior para o tratamento das luxações acromioclaviculares: resultados de 84 casos operados

Abstract

Objective: To evaluate the results from surgical treatment of 84 cases of acute acromioclavicular dislocation, using a posterosuperior access route. Methods: Eighty-four cases of acute acromioclavicular dislocation (grade III in the Allman-Tossy classification) operated between November 2002 and May 2010 were evaluated. The patients' mean age was 34 years. The diagnoses were made using clinical and radiographic evaluations. The patients were operated by the same surgical team, within three weeks of the date of the trauma, using a posterosuperior approach to the shoulder to access the top of the base of the coracoid process for placement of two anchors, which were used in reducing the dislocation. The minimum follow-up was 12 months. The postoperative clinicalradiographic evaluation was done using the modified Karlsson criteria and the University of California at Los Angeles (UCLA) score. Results: 92.8% of the 84 patients treated presented good or excellent results, and 7.2% presented fair or poor results, using the UCLA assessment score. According to the modified Karlsson criteria, 76.2% were assessed as grade A, 17.9% as grade B and 5.9% as grade C. Conclusion: The posterosuperior access route to the shoulder is a new option for accessing the coracoid process and treating acromioclavicular dislocation, with clinical and radiographic results equivalent to those in the literature.

Avaliação pós-operatória comparativa dos pacientes submetidos ao tratamento cirúrgico das luxações acromioclaviculares aguda versus crônica

“…There was no statistically significant difference between the groups. These results are similar to those reported in the Brazilian literature, with 92.8% of good/ excellent cases according to Molin et al 23 and 95.2% according to Scandiuzzi et al 24 Complications were present in 43.3% of our patients, in a rate that is in line with that of other studies, such as those by Ferreira Neto et al 25 (40.9%) and Neviaser 26 (39%). Superficial infection occurred in 14.21% of the cases on subgroup I, and in 11.11% of the subjects in subgroup II.…”

Avaliação dos ligamentos acromioclavicular, coracoclaviculares e coracoclavicular medial na luxação acromioclavicular

“…Descrito como "Ligamento Bicorne" por apresentar dois fascículos principais em 1802 por Leopoldo Caldani, 1 o LCCM também já foi considerado um espessamento da fáscia clavipeitoral, 2 um ligamento coracocostal 3 e até mesmo já teve a sua existência negada. [4][5][6][7][8] O LCCM forma uma faixa de fibras de cor amarelo perolada que se origina da borda medial do processo coracoide por meio de dois fascículos (anterior e posterior), os quais se fundem para formar o corpo ligamentar e insere-se na porção medial da clavícula. 2,9,10 Existem algumas divergências em relação à sua inserção.…”