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At least 235 records · Page 13Linked to original sources
PubMed1996

[Surgical treatment of acute, complete acromioclavicular joint dislocation. Indications, technique and results].

From June 1983 to May 1990, 51 patients were operated on for acute, complete acromioclavicular dislocation (Tossy III). The operative technique includes suturing of the coracoclavicular and acromioclavicular ligaments and stabilization of the clavicle with resorbable, 10-mm coracoclavicular PDS banding. Six patients received primary resection of the lateral end of the clavicle due to significant injury of the AC joint cartilage. Forty-two patients with an average follow-up of 6.1 years were evaluated clinically using the UCLA and Constant-Murley Score, as well as subjective grading. Additional radiological assessment was performed in 36 cases. Excellent or good clinical results were obtained in 97.6%, with 85.7% being free of pain. All patients with primary resection of the lateral end of the clavicle had no pain. The incidence of postoperative complications was low (one deep wound infection with removal of the PDS band, three secondary dislocations). Post-traumatic arthritis developed in 14.7% of the patients. In those cases of acute grade III AC joint dislocations where operative treatment is indicated, this technique provides excellent results with a low complication rate.

Acromioclavicular Joint↗
PubMed2000

Reduction and fixation of sacroiliac joint dislocation by the combined use of S1 pedicle screws and the galveston technique.

STUDY DESIGN: This retrospective study was designed to analyze the results of the treatment with S1 pedicle screws and the Galveston technique of seven patients with sacroiliac dislocation. OBJECTIVES: To evaluate the effectiveness of the combined use of S1 pedicle screws and the Galveston technique for the treatment of sacroiliac dislocation. SUMMARY OF BACKGROUND DATA: Although several procedures for internal fixation of sacroiliac dislocation have been reported, there have been no reports discussing surgical treatment of sacroiliac dislocation by the combined use of S1 pedicle screws and the Galveston technique. METHODS: Seven patients with sacroiliac dislocation were treated with pedicle screws of S1 and iliac rod according to the Galveston technique. In the seven patients, the dislocation was associated with vertical displacement of the sacroiliac joint and rotational deformity of the pelvic ring. They were classified into Type-C pelvic disruption according to the Tile's classification. Three patients with disruption of the symphysis pubis underwent additional fixation of the symphysis using a dynamic compression plate. The remaining four patients were treated by the posterior procedure alone. RESULTS: The vertical displacement was completely reduced in five patients, and the rotational deformity was completely corrected in four patients. The reduction was maintained at the time of the final follow-up evaluation. There were no perioperative complications with the exception of late infection in one patient. CONCLUSIONS: The combined use of S1 pedicle screws and the Galveston technique provided immediate stability and sufficient reduction for sacroiliac dislocation in seven patients in this study. This hybrid internal fixation procedure is useful for reduction and fixation of sacroiliac dislocation associated with the vertical and rotational instability of the pelvic ring.

Adult↗
PubMed2005

A novel treatment of grade III acromioclavicular joint dislocations with a C-hook implant.

INTRODUCTION: This study evaluates the results of the new surgical treatment of complete acromioclavicular (ac) dislocations using coracoclavicular (cc) fixation with a shape memory metal C-hook implant. MATERIALS AND METHODS: Fifteen patients were prospectively analyzed. They all had a Tossy III ac dislocation due to trauma. The ac ligament was reinserted using a surgical bone anchor, and the position of the joint was restored by fixing it with a C-hook. After 3 months the C-hook was removed. Functional status, symptom severity, X-rays and patient satisfaction were analyzed during clinical control visits. The follow-up time was 1 year. RESULTS: At 12 weeks, full shoulder function had been achieved by 93% of the patients. The final control visit showed full recovery of active ROM in all patients. Two patients had mild pain during certain movements. X-rays showed the precise anatomical position of ac joint with no statistically significant differences compared to the healthy side. Patient contentment was excellent in 14 cases and satisfactory in one case. The average sick-leave was 58 days, including the removal operation. Minor osteolysis of the clavicle was noticed in two patients. CONCLUSION: The new C-hook implant provides accurate anatomical reduction, conserves the articular surfaces and enables fast functional recovery with excellent patient contentment. Technically, the implant is easy to use. Based on this study, the C-hook presents a reliable novel treatment option in surgical ac repair.

Acromioclavicular Joint↗
PubMedDate not supplied

Stabilization of acute, complete acromioclavicular joint dislocations with a new C hook implant.

Although coracoclavicular fixation is currently popular for type III acromioclavicular (AC) dislocations, a surgical gold standard is lacking. The purpose of this study was to evaluate the preliminary outcome of surgical treatment of complete AC dislocations with a new nitinol C hook implant. When the implant is cooled (<5 degrees C), it softens enough to be easily inserted under the coracoid process with a hole drilled in the clavicle. Cooling is induced with ice water. When the implant reaches body temperature, it hardens and anatomic reduction is achieved. Patients with acute type III AC dislocations were prospectively evaluated. The AC ligament was reinserted with the use of a bone anchor, and the position of the joint was restored by fixing it with a new C hook. Clinical and radiographic control checkups were carried out at 3, 8, and 12 weeks and 2 years postoperatively. Certain patient-related variables, functional status, symptom severity, and patient satisfaction were assessed. By 12 weeks, all patients had achieved full functional status. Radiographs showed accurate anatomic reduction. Overall subjective satisfaction was very good in all cases. No complications or implant failures occurred. On the basis of this pilot study, the new C hook implant provides secure anatomic reduction with very good functional recovery and patient satisfaction. The main benefit of the implant is the ease of insertion. It preserves the articular surfaces and allows slight movement of the AC joint during abduction of the arm. The C hook implant is a new surgical concept with potentially better patient recovery.

Acromioclavicular Joint↗
PubMed1991

[Results following the surgical treatment of acromioclavicular joint dislocations. A comparison of direct trans- and extra-articular fixation].

During the years 1985-1988, a total of 41 patients were treated for acromioclavicular dislocations. 25 (61%) were followed postoperatively for an average of 21 months. Two different methods of direct fixation of the AC-joint were compared: in 13 patients the transarticular fixation with two Kirschner wires and a 7.5 mm biodegradable Polydioxanon band (group I); in 12 patients an extraarticular fixation with PDS-band alone (group II). In both groups the ruptured ligament were sutured. In the first group physiotherapy was instituted immediately with limitation in abduction range to ninety degrees. After six weeks the Kirschner wires were removed under local anaesthesia and physiotherapy progressed to full range of motion. The shoulders of the second group patients were immobilized for 4 weeks. All of the patients were evaluated at follow-up on a subjective (pain, stiffness), objective (strength, range of motion, stability of the AC-joint) and roentgenographic (degree of displacement, posttraumatic arthritis, calcifications around the injured ligaments) basis. In both groups we saw good and satisfying results in more than 90%. A significant difference exists only as far as rehabilitation time is concerned. It was shorter in group I. In spite of the complications we observed with the metallic implants, which didn't have any negative influence on the results, we prefer the transarticular fixation method, because an immobilization postoperatively is not necessary and the time of rehabilitation is shortened.

Acromioclavicular Joint↗