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Mr Lee Van Rensburg GEASS Munich October 2011. JBJS B Vol 49-A, NO. 4, JUNE 1967.

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Presentation on theme: "Mr Lee Van Rensburg GEASS Munich October 2011. JBJS B Vol 49-A, NO. 4, JUNE 1967."— Presentation transcript:

1 Mr Lee Van Rensburg GEASS Munich October 2011

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

3 Rockwood et al; The Shoulder. 1998: p. 483-553.)

4 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

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7 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

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

9 2011 J Shoulder Elbow Surg (2011) 20, S70-S82 2011

10 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

11 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

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13 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. 2007 Nov;38(11):1247-53


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