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Operative management of acromioclavicular joint injuries
Published in Andreas B. Imhoff, Jonathan B. Ticker, Augustus D. Mazzocca, Andreas Voss, Atlas of Advanced Shoulder Arthroscopy, 2017
Felix Dyrna, Brendan Comer, Augustus D. Mazzocca
The primary static stabilizers of the AC joint include the AC ligaments and CC ligaments. The CC ligaments primarily restrain against excess vertical translation. The conoid ligament provides 60% of the resistance to anterior and superior translation of the clavicle, whereas the trapezoid primarily resists axial compression of the distal clavicle into the acromion.38 Both ligaments originate posterior to the pectoralis minor insertion on the coracoid and traverse the coracoclavicular interspace. The conoid inserts onto the posteroinferior clavicle approximately 45 mm medial to the AC joint on a palpable bony prominence that helps guide tunnel placement for anatomic reconstruction. The trapezoid inserts 25 mm medially to the AC joint and more centrally in the anterior–posterior direction.39
Upper Limb
Published in Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno, Understanding Human Anatomy and Pathology, 2018
Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno
The clavicle or collarbone, is a long bone that connects the scapula to the sternum via the acromioclavicular and sternoclavicular joints (Plates 4.5, 4.7, and 4.8). The acromioclavicular joint is a plane synovial joint between the acromion of the scapula and the lateral end of the clavicle, and is associated with the coracoclavicular ligament—formed by the conoid ligament and the trapezoid ligament—and the coracoacromial ligament (Plate 4.8b). Note that the clinical condition known as shoulder separation refers to a separation between the acromion and the clavicle, that is within the shoulder girdle and not to a separation between this girdle (and namely the scapula) and the humerus (arm), which is called shoulder dislocation. The medial end of the clavicle articulates with the clavicular notch of the manubrium and the adjacent part of the 1st costal cartilage, forming the sternoclavicular joint. This joint is stabilized by the anterior sternoclavicular ligament and the costoclavicular ligament, and its articular disc prevents medial displacement of the clavicle (Plate 4.8a). The saddle shape of the joint surfaces, combined with the articular disc, allows the sternoclavicular joint to function almost as freely as a ball-and-socket joint. As the scapula is directly connected to the clavicle, the sternoclavicular joint is crucial for the protraction (anterior displacement), retraction (posterior displacement), depression, elevation, medial rotation—inferior angle going medially—and lateral rotation—inferior angle going laterally—of the scapula. In addition to these six movements, the scapula can also be adducted (i.e., moved medially, toward the midline; in the human body this movement is normally coupled with a retraction of the scapula) by the rhomboid major and rhomboid minor, and abducted (returned to its original position) mainly by passive movement.
Comparison of the Tight Rope Technique and Clavicular Hook Plate for the Treatment of Rockwood Type III Acromioclavicular Joint Dislocation
Published in Journal of Investigative Surgery, 2018
Leyi Cai, Te Wang, Di Lu, Wei Hu, Jianjun Hong, Hua Chen
An approximately 7-cm-long skin incision was made and the AC joint was exposed subsequently. When the AC joint was reduced and temporarily fixed, clavicular hook plate was positioned with the hook dorsally under the acromion and fixed in the clavicle with screws. Because the trapezoid and conoid ligaments act separately to stabilize the AC joint [18], we focus on anatomical reconstruction of these structures. After the reduction of the dislocation, X-ray was used. The deltoid detachments were repaired using absorbable sutures and the incision was closed in layers after rinse.