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Trastornos de la Articulación acromioclavicular | Separación

Complications After Anatomic Fixation and Reconstruction of the Coracoclavicular Ligaments

Acromioclavicular (AC) joint injuries represent 12 percent of all traumatic shoulder girdle injuries. Historically, surgical reconstruction of a disrupted AC joint has resulted in high complication rates. In recent years, there has been a movement towards anatomic coracoclavicular (CC) ligament fixation and reconstruction. The purpose of this study is to analyze the unique complications associated with these anatomic CC ligament procedures using either cortical fixation buttons (CFBs) or tendon grafts (TGs) and to evaluate the effect that these complications have on patient outcomes.

The study analyzed surgical treatment for AC joint dislocations. This surgical treatement was performed on 3 women (4 shoulders) and 52 men (55 shoulders) with a mean age of 43.6 years (range, 18-71 years); 13 shoulders (22.0%) underwent fixation using the CFB technique, and 46 shoulders (78.0%) underwent reconstruction using the TG technique.


Acromioclavicular Joint Separations

Acromioclavicular (AC) joint injuries are common injuries of the shoulder girdle, and account for nearly half of all shoulder injuries among athletes involved in contact sports. There are varying levels of classification for an AC joint injury. The exact classification dictates the type of treatment. A majority of AC joint injuries can be treated non-operatively, but in severe cases of high-grade AC joint separation surgery is required. Many surgical techniques have been described to stabilize the AC joint, however, the outcome of many of these techniques report failure and complication rates. The purpose of this article is to review the important anatomy, biomechanical background, and clinical management of AC joint injuries.


Acromioclavicular Joint Injuries: Anatomy, Diagnosis and Treatment

Acromioclavicular joint injuries (also referred to as AC joint injuries) are common in athletic populations and account for 40%-50% of shoulder injuries in many contact sports. Most often, lacrosse, hockey, rugby, football, and other sports that involve direct impact are affected. Recent improvements in understanding the biomechanics and anatomy of the AC joint have led to an evolution of new treatments. This clinical focus: Acromioclavicular Joint Injuries: Anatomy, Diagnosis and Treatment features some of the new diagnostic and treatment options associated with AC joint injuries and offers insight on the anatomy of the acromioclavicular joint.  Allograft reconstruction techniques are also reviewed and patient outcomes discussed. Download a copy of Acromioclavicular Joint Injuries: Anatomy, Diagnosis and Treatment below


Inestabilidad de la Articulación Acromioclavicular – Indicaciones y Técnicas de Reconstrucción

Las lesiones de la articulación acromioclavicular (por ejemplo, la dislocación acromioclavicular) son comunes y pueden llevar a inestabilidad o cambios degenerativos que requieran intervención quirúrgica. El espectro de lesiones abarca desde un esguince a una disrupción de los ligamentos acromioclaviculares y coracoclaviculares que proveen estabilidad horizontal y vertical a la clavícula distal. La mayoría de las lesiones son el resultado de un trauma directo a la articulación acromioclavicular. La mayoría de las lesiones pueden ser manejadas de modo no quirúrgico. Sin embargo puede generarse una inestabilidad dolorosa de  existir severa disrupción de las estructuras de soporte que rodean la articulación. Se han descrito múltiples procedimientos de estabilización para la articulación acromioclavicular. Varios de estos han sido abandonados a causa de alta tasa de complicaciones. Las técnicas comunes de reconstrucción incluyen la reconstrucción del ligamento coracoclavicular con o sin resección de la clavícula (Weaver-Dunn modificado) o estabilización coracoclavicular (Mediante Tornillo de Bosworth) con reparación o reconstrucción de los ligamentos coracoclaviculares. El objetivo de este artículo es revisar la anatomía básica, la biomecánica y el tratamiento de la inestabilidad de la articulación acromioclavicular. Palabras clave: inestabilidad de la articulación acromioclavicular (AC), Weaver-Dunn modificado.