• Title/Summary/Keyword: Acute dislocation

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Treatment of Acute Acromioclavicular Joint Dislocation: Kirschner's Wire Trans-acromial Fixation versus AO Locking Hook Plate Fixation

  • Kim, Young-Jun;Chun, Yong-Min
    • Clinics in Shoulder and Elbow
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    • v.19 no.3
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    • pp.149-154
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    • 2016
  • Background: The purpose of this study is to compare clinical and radiological outcomes between trans-acromial fixation with Kirschner's wire (K-wire) and AO locking hook plate fixation for acute acromioclavicular (AC) joint dislocation. Methods: This study included 61 patients who underwent either closed reduction and trans-acromial fixation with K-wire (group A, 23 patients) or open reduction and internal fixation with AO locking hook plate (group B, 38 patients). Pain on a visual analogue scale (VAS) score, the University of California Los Angeles (UCLA) shoulder score, the American Shoulder and Elbow Surgeons (ASES) score, and active range of motion (ROM) were used in the functional evaluation. For radiological evaluation, coracoclavicular distance (CCD) was measured on both clavicular anteroposterior view and compared between groups. Results: At one-year follow-up, no significant differences in VAS pain score, UCLA shoulder score, ASES score, and active ROM were observed between groups, despite five cases (22.7%, 5/23) of complication in group A. The side-to-side difference between normal and affected CCD was $2.4{\pm}2.2mm$ in group A and $0.2{\pm}0.7mm$ in group B. This difference showed a statistical significance between groups (p<0.001). Conclusions: For the treatment of acute AC joint dislocation, the K-wire trans-acromial fixation group showed a significantly greater CCD than the AO locking hook plate group. In addition, during the follow-up period, much higher incidence of complication related to implant was observed in the trans-acromial fixation group. Although clinical outcomes between groups were not significantly different, these results should be interpreted carefully.

Surgical Treatment of Acromioclavicular Dislocation -Comparison of modified Weaver-Dunn method and modified Phemister method- (견봉 쇄골 관절 탈구의 수술적 치료 - Weaver-Dunn 변법과 Phemister 변법의 비교 -)

  • Bae, Ki-Cheol;Sohn, Sung-Won;Cho, Chul-Hyun;Jung, Su-Won
    • Clinics in Shoulder and Elbow
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    • v.9 no.2
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    • pp.155-161
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    • 2006
  • Purpose: To compare the clinical and radiological results between the modified Weaver-Dunn method and modified Phemister method in the acute acromioclavicular joint dislocation. Materials and Methods: We reviewed 19 patients who were treated for the acute acromioclavicular joint dislocation from 2001 to 2002. 10 patients were operated with the modified Weaver-Dunn method (group A) and the others with modified Phemister method (group B). The classification of preoperative injury was analyzed by using the Rockwood system, the clinical assessment of preoperative and postoperative by the modified UCLA rating scale and the radiological assessment by simple x-ray. Results: With the modified UCLA rating scale, group A showed 5 cases(50%) of excellent and 5 cases(50%) of good, group B showed 4 cases(44.4%) of excellent and 5 cases(55.6%) of good. In the radiologic findings of the coracoclavicular distances, group A was 16.2 mm at preoperative, 8.8 mm at postoperative, 9.7 mm at last follow-up and group B was 12.9 mm, 6.7 mm and 7.9 mm respectively. Postoperatively there were no complications such as surgical wound infection and failure of Kirschner wires. Conclusion: Both the modified Weaver-Dunn and modified Phemister methods have shown satisfied clinical and radiologic results, and there was no difference in these result between two groups (p>0.05).

Large Hill-Sachs Lesion Combined with a Rotator Cuff Tear in an Acute Traumatic Anterior Dislocation of the Shoulder in an Elderly Patient Treated with an Allogenic Iliac Tricortical Bone Graft (노인 환자의 급성 외상성 견관절 전방 탈구에서 회전근개 파열과 동반된 거대 Hill-Sachs 병변에 대해 간접 정복 및 지지대 목적의 동종 장골 삼중 피질골 이식을 통한 치료 1예)

  • Hyun, Yoonsuk;Lim, Jinkyu;Baek, Seung-Ha;Park, Jinho;Lee, Seung-Jin
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.2
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    • pp.188-192
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    • 2020
  • An indirect reduction through the bicipital groove and allogenic iliac tricortical bone graft was performed as a treatment for a large Hill-Sachs lesion with a rotator cuff tear in an acute traumatic shoulder joint dislocation in an elderly patient. Six months after surgery, the rotator cuff healing and bone union were confirmed. The patient also showed satisfactory clinical results with 95 points of the American Shoulder and Elbow Surgeons (ASES) shoulder score and active range of motion with 155° flexion, 120° abduction, and 70° external rotation and 30° internal rotation at 90° abduction. The surgical method can be considered for a large Hill-Sachs lesion with rotator cuff tear in an acute traumatic shoulder joint dislocation in elderly patients.

Peroneus Longus Dislocation associated with Trimalleolar Fracture (A Case Report) (족관절 삼과 골절과 동반된 장 비골건 탈구(1예 보고))

  • Hwang, In-Hwan;Kim, Kwang-Yul;Kim, Hyung-Chun;Lim, Moon-Sup;Lee, Ji-Hoon;Cho, Sung-Jun
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.2
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    • pp.227-229
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    • 2009
  • Traumatic dislocation of the peroneus longus tendon is an often unrecognized injury which has been reported to occur most commonly during sports activity. Most acute cases with early detection can be treated by simple repair of the tendon or retinaculum using one of several procedures available. Accurate treatment through a comprehensive evaluation of the ankle injury prevents suboptimal and sometimes unrecorrectable outcomes. The authors experienced concomitantly the peroneus longus tendon dislocation associated with a trimalleolar fracture of the ankle. We report this case a brief review of the literature.

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Operative Treatment of Acute Peroneal Tendon Subluxation in Athletes: A Case Report - 2 Cases (운동 선수에게 발생한 급성 비골건 아탈구의 수술적 치료: 증례 보고-2예)

  • Lee, Jun-Young;Lee, Ja-Yong
    • Journal of Korean Foot and Ankle Society
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    • v.9 no.1
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    • pp.117-120
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    • 2005
  • Acute subluxation of the peroneal tendon is an uncommon injury which is predominantly associated with a trauma. Traumatic peroneal tendon subluxation in athletes is an uncommon cause of ankle pain. As a result, the diagnosis is often delayed. Numerous surgical techniques have been described for chronic peroneal subluxation or dislocation, however reports in acute cases are rare. Authors experienced two cases of acute subluxation of peroneal tendon in athletes which were treated by simple primary repair of superior peroneal retinaculum with good results.

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All-arthroscopic, Guideless Single Suture-button Fixation of Acute Acromioclavicular Joint Dislocation: A Description of the Technique and Early Treatment Results

  • Altintas, Burak;Yildiz, Fatih;Uzer, Gokcer;Kapicioglu, Mehmet;Bilsel, Kerem
    • Clinics in Shoulder and Elbow
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    • v.20 no.2
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    • pp.59-67
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    • 2017
  • Background: The purpose of this study was to examine the clinical and radiological results of the all-arthroscopic, suture-button fixation technique to treat acute acromioclavicular (AC) joint separations. Methods: All patients with acute AC joint separations received all-arthroscopic, single suture-button (TightRope) procedure without a special guide. Postoperative Constant score (CS), pain level according to visual analogue scale, and range of motion (ROM) were evaluated. For radiological evaluation, coracoclavicular distances were measured bilaterally. Results: Between December 2010 and June 2012, 18 consecutive patients (4 women and 14 men; mean age, 29.3 years) with acute AC joint separations underwent surgical treatment after 6.4 days (range, 2-20 days) following the initial trauma. The average postoperative follow-up was 16.9 months. The mean CS was 92.4 (range, 84-96). The mean external rotation, forward flexion, and abduction were $75.8^{\circ}$ (range, $50^{\circ}-90^{\circ}$), $170^{\circ}$ (range, $150^{\circ}-180^{\circ}$), and $163.8^{\circ}$ (range, $140^{\circ}-180^{\circ}$), respectively. Five patients exhibited coracoclavicular ossifications. In two patients, superficial wound infections were successfully treated with antibiotic therapy. In one patient, a coracoid fracture was observed. No significant differences were found regarding pain, ROM, or strength parameters between both sides. The coracoclavicular distance was discovered to be approximately 2.8 mm greater on the affected side; however, this minimal reduction loss did not affect the functional results. Conclusions: The findings of this study suggests that all-arthroscopic treatment of AC joint separations using the single suture-button technique without a drill guide is safe, yielding good to excellent clinical results.

Effect of cigarette smoking on the maintenance of reduction after treatment of acute acromioclavicular joint dislocation with hook plate fixation

  • Jee-Hoon Choi;Yong-Min Chun;Tae-Hwan Yoon
    • Clinics in Shoulder and Elbow
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    • v.26 no.4
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    • pp.373-379
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    • 2023
  • Background: The purpose of this study was to determine the association between smoking and clinical outcomes of hook plate fixation for acute acromioclavicular (AC) joint injuries. Methods: This study retrospectively investigated 82 patients who underwent hook plate fixation for acute AC joint dislocation between March 2014 to June 2022. The patients were grouped by smoking status, with 49 in group N (nonsmokers) and 33 in group S (smokers). Functional scores and active range of motion were compared among the groups at the 1-year follow-up. Coracoclavicular distance (CCD) was measured, and difference with the uninjured side was compared at initial injury and 6 months after implant removal. Results: No significant differences were observed between the two groups in demographic factors such as age and sex, as well as parameters related to initial injury status, which included time from injury to surgery, the preoperative CCD difference value, and the Rockwood classification. However, the postoperative CCD difference was significantly higher in group S (3.1±2.6 mm) compared to group N (1.7±2.4 mm). Multivariate regression analysis indicated that smoking and the preoperative CCD difference independently contributed to an increase in the postoperative CCD difference. Despite the radiographic differences, the postoperative clinical outcome scores and active range of motion measurements were comparable between the groups. Conclusions: Smoking had a detrimental impact on ligament healing after hook plate fixation for acute AC joint dislocations. This finding emphasizes the importance of smoking cessation to optimize reduction maintenance after AC joint injury. Level of evidence: III.

Coracoclavicular Ligament Augmentation Using TightRope® for Acute Acromioclavicular Joint Dislocation : Surgical Technique and Preliminary Results (TightRope®를 이용한 급성 견봉 쇄골 관절 탈구의 치료 : 수술 술기 및 예비 보고)

  • Cho, Chul-Hyun;Sohn, Sung-Won;Kang, Chul-Hyung;Oh, Geon-Myeoung
    • Clinics in Shoulder and Elbow
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    • v.11 no.2
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    • pp.165-171
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    • 2008
  • Purpose: The purpose of this study was to introduce a new surgical technique and to evaluate the preliminary results after operative treatment with using TightRope$^{(R)}$ for treating acute acromioclavicular joint dislocation. Material and Methods: We studies 10 patients who were followed up for more than 6 months after operative treatment with using an TightRope$^{(R)}$. A longitudinal incision approximately 4cm in length was made from 1cm medial to the acromioclavicular joint to the coracoid process, and then coracocalvicular ligament augmentation using TightRope$^{(R)}$ was done after splitting the deltoid. For postoperative stability, two 1.6 mm Kirschner wires were inserted temporarily across the acromioclavicular joint in all cases. The radiologic results on the serial plain radiographs and the clinical results according to the UCLA score were analyzed. Results: Radiologically, 7 cases showed anatomical reduction, 2 cases showed a slightly loss of reduction and 1 case showed partial loss of reduction. Clinically, 6 cases were excellent, 3 cases were good and 1 case was fair. Conclusion: Coracoclavicular ligament augmentation using TightRope$^{(R)}$ for treating acute acromioclavicular joint dislocation is a minimally invasive, safe procedure that provides satisfactory radiologic and clinical preliminary results. Yet the long-term results have to be analyzed to determine the final results of this procedure.

Arthroscopic Medial Plication using Pull-out Suture for the Treatment of Acute or Recurrent Patellar Dislocation - Technical Note - (급성 또는 재발성 슬개골 탈구의 치료에 있어서 견인 봉합술을 이용한 관절경적 내측 관절막 중첩술 - 수술 술기 -)

  • Ahn, Jin-Hwan;Kim, Jae-Hoon;Ha, Hae-Chan
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.2
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    • pp.214-218
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    • 2006
  • Purpose: We describe a new technique of arthroscopic medial plication using pull-out suture with consideration of anatomical location of medial patellofemoral ligament for the treatment of acute or recurrent patellar dislocation. Operative technique: Under arthroscopic examination, sutures are passed through the medial capsule, at which medial patellofemoral ligament is located, from outside to inside of knee joint. Three guide wires are inserted from anterior surface of the patella to upper half of its medial border. Intraarticular portions of sutures are pulled out toward anterior surface of the patella through bony tunnels. Under appropriate tension, the sutures are tied after performing lateral retinacular release. Conclusion: As suturing medial patellofemoral ligament, this technique can maximize the effect of medial plication and can correct subluxation and tilt of the patella. It seems to be a minimally invasive, easy and effective method for the treatment of acute or recurrent patellar dislocation.

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