- classification of AC separation
- acromioclavicular joint stresses views
- grade I injuries remain nondisplaced;
- type I and type II injuries can be differentiated on stress radiographs;
- w/ pt standing, 10 lb weight is secured to affected upper limb;
- w/ grade II injury, suspended wt displaces AC joint articulation, which increases distance between clavicle & acromion;
- zanca view
- scapular outlet view
- cross body adduction view:
- grade IIIA injuries: defined by a stable AC joint without overriding of the clavicle on the cross-body adduction view
- unstable grade IIIB injury: defined by overriding clavicle on the cross-body adduction view
- Radiological evaluation of the acromioclavicular joint.
- ISAKOS upper extremity committee consensus statement on the need for diversification of the Rockwood classification for acromioclavicular joint injuries.
- Bilateral weighted radiographs are required for accurate classification of acromioclavicular separation: an observational study of 59 cases.
- reconstruction w/o tendon graft:
- consider direct verticle suture limb(s) and a second suture limb running more lateral to engage lateral edge of clavicle
(to reproduce trapezoid ligament);
- A Modified Technique of Reconstruction for Complete Acromioclavicular Dislocation: a Prospective Study.
- Stability of acromioclavicular joint reconstruction: biomechanical testing of various surgical techniques in a cadaveric model.
- A cadaveric study examining acromioclavicular joint congruity after different methods of coracoclavicular loop repair.
- Consistency of long-term outcome of acute Rockwood grade III AC joint separations after K-wire transfixation.
- Mid-term outcome comparing temporary K-wire fixation versus PDS augmentation of Rockwood grade III acromioclavicular joint separations.
- Failure of Coracoclavicular Artificial Graft Reconstructions from Repetitive Rotation
- Mid to long-term results of open AC-joint reconstruction using polydioxansulfate cerclage augmentation.
- Triple endobuttton technique for the treatment of acute complete acromioclavicular joint dislocations: preliminary results.
- reconstruction with tendon graft: (palmaris longus, gracilis, semitendinosis)
- surgical technique:
- transverse incision over distal clavicle;
- deltotrapezial fascia is then divided, exposing distal clavicle;
- superior aspect of the coracoid neck is exposed, and the soft tissue is elevated.
- curved suture passer is placed medial to lateral under coracoid to retrieve suture in gracilis tendon graft and pull it
- conoid limb of the graft
- 4- to 5-mm hole is drilled in the posterior half of the distal clavicle, 45 mm from the distal end of clavicle;
- trapezial limb of graft
- 4- to 5-mm hole is drilled centerline on the clavicle 15 mm lateral to the first hole to accommodate the
trapezial limb of the graft;
- distal clavicle excision
- the distal 8 mm of the clavicle are excised with an oscillating saw.
- tendon passage and fixation:
- free ends of the graft then are advanced through the clavicle drill holes and crossed (opposed);
- distal clavicle is held reduced, and the graft is tensioned, and tendons are sutured
- remaining sutures are then brought laterally to the AC joint and sutured to the acromion;
- Acromioclavicular joint dislocation: a comparative biomechanical study of the palmaris-longus tendon graft reconstruction with other augmentative methods in cadaveric models.
- Reconstruction of the Coracoclavicular Ligaments with Tendon Grafts: a Comparative Biomechanical Study.
- Anatomical acromioclavicular ligament reconstruction: a biomechanical comparison of reconstructive techniques of the acromioclavicular joint.
- Clinical outcomes of coracoclavicular ligament reconstructions using tendon grafts.
- Acromioclavicular joint reconstruction using peroneus brevis tendon allograft.
- Clavicular fractures following coracoclavicular ligament reconstruction with tendon graft: a report of three cases.
- Type III Acromioclavicular Separation: Rationale for Anatomical Reconstruction
- Clinical Results of Single-Tunnel CC Ligament Reconstruction Using Autogenous Semitendinosus Tendon
- Semitendinosus tendon graft versus a modified Weaver-Dunn procedure for acromioclavicular joint reconstruction in chronic cases: a prospective comparative study.
- Clavicular Bone Tunnel Malposition Leads to Early Failures in Coracoclavicular Ligament Reconstructions
The acromioclavicular joint in rheumatoid arthritis.
Osteolysis of the distal part of the clavicle in male athletes.
Bioabsorbable Screw Fixation in Coracoclavicular Ligament Reconstruction
Associated Lesions Requiring Additional Surgical Treatment in Grade 3 Acromioclavicular Joint Dislocations
- modified weaver dunn procedure: (for chronic injuries)