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Surgery of the Shoulder
Published in Timothy W R Briggs, Jonathan Miles, William Aston, Heledd Havard, Daud TS Chou, Operative Orthopaedics, 2020
Nick Aresti, Omar Haddo, Mark Falworth
In acute cases (<3–4 weeks after injury) the coracoclavicular ligaments and superior acromioclavicular capsule/ligament can be repaired and then supplemented with one of the stabilising techniques described earlier. A Weaver-Dunn ligament transfer is not required.
A to Z Entries
Published in Clare E. Milner, Functional Anatomy for Sport and Exercise, 2019
The acromioclavicular joint is also considered part of the shoulder girdle, since the acromion process is part of the scapula. Several ligaments connect the clavicle to the scapula. At this joint, the acromioclavicular ligament is a thickening of the joint capsule, equivalent to the glenohumeral ligament at the glenohumeral joint. In addition, coracoclavicular ligaments, between the coracoid process and the clavicle assist in keeping the clavicle in place. These ligaments attach to the clavicle medial to the acromioclavicular joint and connect to the coracoid process inferiorly. There are two distinct coracoclavicular ligaments, the trapezoid and conoid, named according to their shape (trapezoidal and cone-shaped). The conoid is the more medial of the two. The important role of these ligaments becomes apparent after an acromioclavicular joint separation. This injury is a dislocation of the acromioclavicular joint which typically occurs as a result of a fall directly onto the shoulder. The severity of the injury is determined by the degree of separation of the clavicle from the acromion process. If only the acromioclavicular joint is torn, there is no apparent separation of the joint because the coracoclavicular ligaments keep the clavicle in place. In a more severe injury, the coracoclavicular ligaments are also torn, and the clavicle is now free to move superiorly and become separated from the acromion. In this case, the lateral end of the clavicle can be identified clearly under the skin as a bump on the superior aspect of the shoulder.
Anatomy and biomechanics of the shoulder
Published in Andreas B. Imhoff, Jonathan B. Ticker, Augustus D. Mazzocca, Andreas Voss, Atlas of Advanced Shoulder Arthroscopy, 2017
Lucca Lacheta, Bastian Scheiderer
Beside the coracoclavicular ligaments, which stabilize the clavicle in the vertical direction, the acromioclavicular ligament strengthens the AC-capsule, preventing enhanced horizontal translation.4 The AC ligament can be separated into a superoposterior bundle and the anteroinferior bundle. The superoposterior bundle runs posteriorly toward the distal clavicle from the acromion at an average angle of 30° to the joint surface.5
Acromioclavicular joint injuries at a Colorado ski resort
Published in The Physician and Sportsmedicine, 2023
Naomi Kelley, Lauren Pierpoint, Jack Spittler, Morteza Khodaee
Acromioclavicular joint (ACJ) injuries (also known as separations or dislocations) are very common, accounting for up to forty percent of all shoulder injuries [1–4]. The AC joint is a diarthrodial joint where the clavicle can rotate and translate anteriorly, posteriorly and inferiorly in relation to its articulation with the acromion. The joint is composed of a meniscus-type structure of hyaline cartilage, surrounded by synovium [2]. Stability of the ACJ is provided horizontally by the acromioclavicular ligament, and vertically by the coracoacromial ligament. Although not directly attached to the acromion, two coracoclavicular ligaments (conoid and trapezoid ligaments) provide further vertical stability to the joint [5]. Overall, the anatomy of the ACJ provides resistance against significant forces.
Feasibility Analysis and Clinical Applicability of a Modified Type V Resection Method for Malignant Bone Tumors of the Proximal Humerus
Published in Journal of Investigative Surgery, 2020
Qing Liu, Zhibing Dai, Junshen Wu, Suzhi Ji, Jingping Bai, Renbing Jiang
The negative margin was determined by rapid frozen pathological examination of the cut edge bone and bone marrow cavity. After the tumor was resected, a customized prosthesis was implanted into the corresponding position, and fixed with bone cement. Allograft bone was implanted at the junction of the prosthesis and the humerus stem. A cable was firmly fixed, and the anteversion angle of the humeral head was adjusted. We used an artificial mesh patch to reconstruct the coracoclavicular ligament, the acromioclavicular joint and the surrounding soft tissue, and reattached the coracobrachialis and short head of the biceps brachii to the coracoid process.
Is the Position of Coracoid Button Important in Acromioclavicular Joint Dislocation Treatment with the Suture-Button?
Published in Journal of Investigative Surgery, 2021
The operative treatment of acromioclavicular joint dislocations has a longstanding history [4]. The initial interest in effective operative repairs was primarily due to the need to alleviate the long-term pain in the area as well as to remove the cosmetic defect dominating over the shoulder line because of the dislocation of the distal clavicular end. Initially, less attention was paid to the consequences in activity function of the dislocated clavicula or to the over-stiffening of the undertaken repairs for the whole shoulder complex. The treatment method of dynamic reconstruction of the damaged coracoclavicular ligaments, presented in the paper “Position of coracoid button predicts loss of reduction in acromioclavicular joint dislocation patients treated with the suture-button,” fulfills contemporary expectations pertaining to repairs of acromioclavicular joint dislocations [5]. The value of this study lies not only in the underlined positive sides of the method, but most of all, in the open presentation of the failures and the analysis of their causes. The authors critically evaluate the outcomes of their repairs and search for the reasons of the loss of the initially good functional outcomes in the form of instability with all its consequences. The results presented in many publications amount for the most part to descriptions of physical ability of the operated limbs without paying special attention to groups of patients whose results were poor or bad [6, 7]. However, based on the presented research, the use of the endobutton technique proves to be important with the course of the bone canals in the coracoid and the clavicle. A detailed and technical description of the method and location of placement of the endobutton plates is particularly significant in everyday traumatological practice. It allows for the prevention of failures for therapeutical teams that yield to commercially offered demonstrations of operative techniques.