Abstract
Consensus is lacking for the diagnosis and optimal treatment of unstable acromioclavicular (AC) joint injuries. AC joint injuries have classically been understood and classified from a two-dimensional perspective dating back to the Rockwood classification. The current classification does not consider key clinical examination elements and the role of the scapula. More recent work highlights the three-dimensional form and function of the AC joint and role of the scapula with AC joint injuries. The clavicle serves a key role as a mobile strut for scapular and arm motion. The AC joint serves as a unifying link in the screw axis mechanism that governs normal scapulohumeral rhythm and the three-dimensional nature of the normal kinematics of the clavicle and scapula facilitate arm function.
There are over 150 described operative techniques for AC joint reconstruction, and there is limited data to support one technique over another. Both anatomic and nonanatomic reconstruction techniques have been described. More recent work with anatomic reconstruction of the coracoclavicular ligaments along with acromioclavicular ligament reconstruction provides three-dimensional (3D) restoration. We present our operative technique designed to anatomically restore the AC ligaments, coracoclavicular ligaments, and retain the distal clavicle to restore scapular and AC joint stability.
The purpose of the present chapter is to describe AC joint anatomy and function, pathophysiology of AC joint separations, and discuss a novel anatomic reconstruction technique with functional and radiographic outcome data. We also propose a grading system and a surgical decision-making process aided by physical examination and evaluation of the scapula.
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Morris, B.J., Dome, D., Sciascia, A.D., Ben Kibler, W. (2017). The Scapula and Acromioclavicular Joint Separation and Arthritis. In: Kibler, W., Sciascia, A. (eds) Disorders of the Scapula and Their Role in Shoulder Injury. Springer, Cham. https://doi.org/10.1007/978-3-319-53584-5_9
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DOI: https://doi.org/10.1007/978-3-319-53584-5_9
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