Treatment of the Acromioclavicular Joint Dislocation with External Fixation Device Chelnokov A.N. Tyrtseva E.S. Ural Scientific Research Institute of Traumatology.

Slides:



Advertisements
Similar presentations
M.P. Muldoon, M. D. Orthopedic Medical Group of San Diego.
Advertisements

Rotator cuff tearing and treatment
Mr Lee Van Rensburg GEASS Munich October JBJS B Vol 49-A, NO. 4, JUNE 1967.
The Knee Is a Joint More specifically … A LEG JOINT.
Weaver Dunn Technique for AC Joint Repair
Complex Ligament Injuries of The Knee
Acromioclavicular Separations: Etiology & Treatment
New Technique in Shoulder Surgery for Sports Injury Dennis Crawford MD, PhD Assistant Professor Surgical Director, Sports Medicine Program Department of.
Skiing and Snowboarding Injury Prevention and Treatment
OKU REVIEW CHAPTER 24 – SHOULDER INSTABILITY. 24 year male presents with a traumatic shoulder dislocation that was reduced. He is now 3 days out and in.
EFFECTS OF HAMSTRING TENDON VS PATELLAR TENDON GRAFTS ON KNEE STABILITY FOLLOWING ACL RECONSTRUCTION Adrien Brudvig and Sha’ Howard ESS 265 A Research.
Oct, 3 to Ankara Arthroscopi Postero-lateral Reconstruction M. Razi. MD; Rasoul Akram University Hospital Tehran.
Injuries to the Shoulder
Bankart Lesion Thomas J Kovack DO.
External Fixation Indications and Techniques
Rotator Cuff Tears Thomas J Kovack DO. Rotator Cuff Tears.
National Olympic Academy of I.R. IRAN Sports Medicine & Science Department Dr M Taghavi Sport physician of Olympic Academy
Continuous Passive Motion (CPM)
Re-written by: Daniel Habashi Upper Extremity Fractures And Dislocations.
By: Sydney and Emma Shoulder Problems and Treatments.
Ch. 21 Shoulder Injuries. Impingement Syndrome Space between humeral head below and acromion above becomes narrowed The structures that live in that space.
Hajer Ali Sarah Sameer. What is dislocation of the shoulder? What causes a shoulder dislocation? The shoulder joint is the most mobile joint in the body.
Mr. Nnamdi Obi Specialist registrar United Kingdom
Rehabilitation Techniques Jenna Page, M.Ed., ATC November 2008.
Acute Injuries of the Shoulder. Separated Shoulder Def: A sprain of the acromioclavicular ligament MOI: A fall on the outstretched arm or a blow the.
SPU Medical Faculty English 3 What Is Orthopedics? M.A.Kubtan MD - FRCS.
What is Patellar Dislocation? The cause: Patients with normal anatomy and had a traumatic event. -OR- Patients with predisposing anatomy and a history.
Superior Labral Anterior to Posterior (SLAP) Tears Thomas J Kovack DO.
HENRY T. GOITZ, MD Academic Chief – Sports Medicine Institute Director – Education, Research, Injury Prevention Center Co-Director – Orthopaedic Sports.
ACL Injuries (Anterior Cruciate Ligament Injuries)
Colles’ Fractures Charles Caltagirone.
A RTHROSCOPIC A CROMIOPLASTY Angela Whittington. DEFINITION Bursitis or tendonitis  impingement Causes the tissues underneath the AC joint to be pinched.
Shoulder Injuries by: Nanda K. Sinha, M.D.. Surface Anatomy.
Evolving Role of Reverse Shoulder Replacement Derek Cuff, M.D. Suncoast Orthopaedic Surgery and Sports Medicine Gulfcoast Orthopaedic Rehab Conference.
By: Nathaniel Patterson
Arthroscopic Treatment of Tibial Plateau Fractures John F. Meyers, M.D.
Shoulder Instability and the Role of PT/OT Derek Cuff, M.D. Suncoast Orthopaedic Surgery and Sports Medicine.
Shoulder Injuries Surgical Consideration John F. Meyers, M.D.
Musculoskeletal Injuries. Definition Any injury that occurs to a skeletal muscle, tendon, ligament, joint, or a blood vessel that services skeletal muscle.
Shoulder Pain/Impingement Matthew E. Mitchell M.D.
PILON EXTERNAL FIXATION LAB. Theory of External Fixation  “Damage Control”  Provides stability while letting the soft tissues heal  Does not burn bridges.
Chapter 28 and 29 Post Surgical Rehabilitation. Overview Although many musculoskeletal conditions can be treated conservatively, surgical intervention.
Continuous Loop Double Endobutton Reconstruction for AC Joint Dislocation Steven Struhl, MD 1, Theodore Wolfson, MD 1 1 Department of Orthopaedic Surgery,
How I Do MCL Repair M. Razi MD;. Anatomy Medial structures MCL POL postero-medial capsular ligament Augmented by dynamic effect of semimembranosus.
Shoulder Injuries Part I
EVALUATION OF THE PAINFULL SHOULDER NICK KILMER, MD Primary Care Sports Medicine, University of Rochester RRFMC, OCTOBER 1, 2011 For unabridged PowerPoint,
Shoulder Pain: problems and solutions Ms. Ruth A. Delaney Consultant Orthopaedic Surgeon, Shoulder Specialist.
Surgical Treatment Of Acromioclavicular Dislocations: A Comparative Study Of Suture Ethiband N:5 With Semitendinosus Autograft Tendon Mohsen Mardani-Kivi.
Injuries to the Shoulder. I. Anatomy A. Bones 1. Humerus.
Athletic Shoulder Injuries Sean F. Bak, MD Sports Medicine and Shoulder Reconstruction Novi, MI.
1 Shoulder Problems. 2 Shoulder has most ROM of any joint Shoulder has most ROM of any joint Patient complains of pain or instability Patient complains.
Bankart Procedure By: Cassie Bobzin, Laura Erickson, Morgan Griebel, Alexis Mesman.
Kristine A. Karlson, MD Dartmouth Medical School Community and Family Medicine/ Orthopaedics Physical Examination of the Shoulder.
A Thesis Presented to the Graduate School Faculty of Medicine, University of Alexandria In partial fulfilment of the requirements of the Master Degree.
WHAT IS HAND THERAPY? WHAT IS HAND THERAPY? Treating more than just a hand… Hand Therapy Week [Insert dates]
TRAUMATIC SHOULDER CONDITIONS
KAITLIN TORTORICH POST-ACL REPAIR ROM DEFICIENCY CASE STUDY:
ACL Reconstruction and Postop Rehabilitation
Shoulder 101 Lutul D. Farrow, MD University Medical Center
Tissue Response to Injury
1st Zliten Orthopedic Symposium (ZOS) 10th March,2016
Waleed Mohamed Amrhassaen Mohammad Salah Abdelaal
Conflict of interests The speaker has the following to disclose related directly or indirectly to the subject of this presentation (period: past three.
Chapter 69 Management of Patients With Musculoskeletal Trauma
HSC PDHPE – CQ3 DP4 CQ3 – What role do preventative actions play in enhancing the wellbeing of the athlete?
Chelnokov A.N. Tyrtseva E.S.
Sports Medicine & Science Department
Bankart Lesion Thomas J Kovack DO.
Arthroscopy Surgery in Delhi
Presentation transcript:

Treatment of the Acromioclavicular Joint Dislocation with External Fixation Device Chelnokov A.N. Tyrtseva E.S. Ural Scientific Research Institute of Traumatology and Orthopaedics, Ekaterinburg, Russia

Background To date there has been no consensus about optimal treatment of the traumatic dislocation of the acromio-clavicular joint. To date there has been no consensus about optimal treatment of the traumatic dislocation of the acromio-clavicular joint.

Many treatment modalities for the ACJ dislocation From aggressive surgery… From aggressive surgery…

…to nonoperative management –A Prospective Evaluation of Untreated Acute Grade III Acromioclavicular Separations. T.F. Schlegel. The American Journal of Sports Medicine 29: (2001): –20 of the 25 patients completed the 1-year evaluation and strength-testing protocol; –objective examination and strength testing of the 20 patients revealed no limitation of shoulder motion in the injured extremity and no difference between sides in rotational shoulder muscle strength

Aim of this study was to estimate capabilities of small wire monolateral external fixator for closed treatment of complete acromioclavicular dislocations. Aim of this study was to estimate capabilities of small wire monolateral external fixator for closed treatment of complete acromioclavicular dislocations.

Material and methods 24 patients 24 patients –14 male –10 female 3,2 days after the injury (0-14) 3,2 days after the injury (0-14)

External Fixation G.S.Sushko, G.A.Ilizarov, 1977, 1979 G.S.Sushko, G.A.Ilizarov, 1977, 1979

Surgery and post-op period minutes minutes Regional anesthesia Regional anesthesia Discharge in 1-2 days Discharge in 1-2 days Sling for 1-3 days Sling for 1-3 days

Duration of fixation 4 weeks for acute cases (fixation within 0- 5 days after the injury), 4 weeks for acute cases (fixation within 0- 5 days after the injury), 6-8 weeks for delayed admission (6-14 days) 6-8 weeks for delayed admission (6-14 days) In cases of dislocations older 2 weeks => AC and CC ligaments repair by tendon allografts In cases of dislocations older 2 weeks => AC and CC ligaments repair by tendon allografts Stability test before hardware removal Stability test before hardware removal

Results Self-care, light housework – 3-5 days Self-care, light housework – 3-5 days Deep infection 0/24 Deep infection 0/24 –10 patients (42%) sustained skin irritation and serum drainage from acromial wire site only 23/24 healed 23/24 healed –1/24: missed acromial wire cut-out => symptomatic instability => AC+CC repair (allo tendons) => uneventful healing 1 year follow up - 15 patients. 1 year follow up - 15 patients. –All restored their pre-injury status –Occasional pain in hyperabduction – 3/15

Rockwood type V injury

After 6 weeks

Result

Neer Type II injury

Follow-up (3 year)

Follow-up (3 years) Affected side

Discussion: Advantages of the technique Controllable fixation Controllable fixation –With ex-fix we control the situation, without it the situation controls us Minimally invasive Minimally invasive –Fast recovery –Good cosmetic effect Minimal time and efforts Minimal time and efforts Short learning curve Short learning curve

Discussion: Disadvantages Temporary discomfort, decreased quality of life Temporary discomfort, decreased quality of life Pin site care, outpatient visits necessary Pin site care, outpatient visits necessary Hardware removal Hardware removal

Conclusion External fixation can be technique of choice for acute cases where operative treatment is indicated External fixation can be technique of choice for acute cases where operative treatment is indicated

Thank you