Mr Lee Van Rensburg GEASS Munich October 2011

JBJS B Vol 49-A, NO. 4, JUNE 1967

Rockwood et al; The Shoulder. 1998: p )

AC ligaments disrupted ACJ dislocated CC ligaments disrupted CC interspace > than normal shoulder (25-100% more than the normal shoulder) Deltoid and trapezius muscles usually detached from the distal end of the clavicle Delto trapezial fascia intact Type V CC 100% to 300% more than normal Rockwood et al; The Shoulder. 2004: p. 533

Relative rest Sling comfort ROM Nothing heavier than cup of tea 6/52 No contact sport 3/12 F/U 6/52 Salvage Modified Weaver Dunn 4 strands 1 PDS

JBJS B Vol 49-A, NO. 4, JUNE 1967

2011 J Shoulder Elbow Surg (2011) 20, S70-S

Sling 3 to 4 weeks ROM exercises followed by progressive strengthening Rehabilitation protocols should be followed diligently inadequate rehabilitation can be a source of persistent pain and instability of the ACJ Return to sports once Full, painless range of motion May require 3 months J Shoulder Elbow Surg (2011) 20, S70-S82

Favourable outcome in 80% of patients at 1 and 5 years Functional deficits are minimal, Strength similar to that of the contralateral shoulder 1 report of 17% loss of bench press strength Persistent ACJ tenderness, instability, shoulder stiffness, and cosmetic deformity may require surgery J Shoulder Elbow Surg (2011) 20, S70-S82

Chronic acromioclavicular disruption Eleven men Average age of 39 Follow up 55 months 10 patients achieved a good/ excellent result 1 patient had fracture of the base of the coracoid after heavy lifting in the early postoperative period which resulted in a poor outcome. 2 patients needed an additional operation Excision of the lateral end of the clavicle and removal of screw ASD Injury Nov;38(11):