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Treatment of Acromioclavicular Injuries, Especially Complete Acromioclavicular Separation
634
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0
References
1972
Year
Shortened Coraco-acromial LigamentsSurgeryAcromioclavicular InjuriesOrthopaedic SurgeryThrombosisOsteoarthritisOrthopaedicsResection ArthroplastyArthroscopic TechniqueJoint ReplacementDirect TraumaRheumatoid ArthritisRheumatologyKnee InjuriesTrauma SurgeryAnkle TraumaShoulder SurgeryMusculoskeletal SurgeryMedicineAnticoagulant
Acromioclavicular injuries are classified into three types: I involves direct trauma without ligamentous tears, II involves ligamentous injury with instability but intact coracoclavicular ligaments, and III involves complete instability with disruption of both ligament sets. The study presents a treatment schema for the three types of acromioclavicular injuries based on their pathological changes. Treatment involves expectant management for early Type‑I and Type‑II injuries, resection arthroplasty for late or symptomatic cases, and a novel surgical procedure combining resection arthroplasty with clavicular fixation by suturing the acromial end of the shortened coraco‑acromial ligaments into the clavicle’s medullary canal for acute and chronic Type‑III injuries. In fifteen acute and chronic cases, the outcomes were quite favorable.
A schema of treatment of the three types of acromioclavicular injuries, based [See table in the PDF file] on pathological change in each, is presented. Type-I injuries are those with direct trauma to the acromioclavicular joint without significant ligamentous tears or intability. Type-II injuries are those with acromioclavicular ligamentous injury and instability but without disruption of the coracoclavicular ligaments. Type-III injuries are those with complete clavicular instability and disruption of both sets of ligaments. Type-I injuries are treated expectantly when seen early, and when seen late, with acromioclavicular arthritis, they are treated by resection arthroplasty. Expectant treatment is advocated for early Type-II injuries while late symptomatic Type-II separations are treated by resection arthroplasty of the acromioclavicular joint. Those patients with acute and chronic Type-III injuries are treated surgically by a new operation which combines resection arthroplasty of the acromioclavicular joint with fixation of the clavicle in an anatomical position by suture of the acromial end of the shortened coraco-acromial ligaments into the medullary canal of the clavicle. The results in both acute and chronic cases, fifteen in number, have been quite good.