nach oben

Surgical and Radiologic Anatomy

Erschienen in:

01.09.2012 | Anatomic Bases of Medical, Radiological and Surgical Techniques

Measure of horizontal and vertical displacement of the acromioclavicular joint after cutting ligament using X-ray and opto-electronic system

verfasst von: Goulven Rochcongar, Sébastien Emily, Benoit Lebel, Vincent Pineau, Gilles Burdin, Christophe Hulet

Erschienen in: Surgical and Radiologic Anatomy | Ausgabe 7/2012

Einloggen, um Zugang zu erhalten

Abstract

Introduction

Surgical versus orthopedic treatments of acromioclavicular disjunction are still debated. The aim of this study was to measure horizontal and vertical acromion’s displacement after cutting the ligament using standard X-ray and an opto-electronic system on cadaver.

Materials and methods

Ten cadaveric shoulders were studied. A sequential ligament’s section was operated by arthroscopy. The sequence of cutting was chosen to fit with Rockwood’s grade. The displacement of the acromion was measured on standard X-ray and with an opto-electronic system allowing measuring of the horizontal displacement. Statistical comparisons were performed using a paired Student’s t test with significance set at p < 0.05.

Results

Cutting the coracoclavicular ligament and delto-trapezius muscles cause a statistical downer displacement of the acromion, but not after sectioning the acromioclavicular ligament. The contact surface between the acromion and the clavicle decreases statistically after sectioning the acromioclavicular ligament and the coracoclavicular ligament with no effect of sectioning the delto-trapezius muscles. Those results are superposing with those dealing with the anterior translation.

Discussion

The measure concerning the acromioclavicular distance and the coracoclavicular distance are superposing with those of Rockwood. However, there is a significant horizontal translation after cutting the acromioclavicular ligament. Taking into account this displacement, it may be interesting to choose either surgical or orthopedic treatment.

Conclusion

There is a correlation between anatomical damage and importance of instability. Horizontal instability is misevaluated in clinical practice.

Level of evidence

Basic science study.

Alyas F, Crutis M, Speed C, Saifuddin A, Connell D (2008) MR imaging appearances of acromioclavicular joint dislocation. Radiographics 28:463–479. doi:10.1148/rg.282075714 PubMedCrossRef

Bossart MJ, Joyce FM, Manaster P, Packer M (1988) Lack of efficacy of ‘weighted’ radiographs in diagnosing acute acromioclavicular separation. Ann Emerg Med 17:20–24. doi:10.1016/S0196-0644(88)80497-9 PubMedCrossRef

Calvo E, López-Franco M, Arribas IM (2006) Clinical and radiologic outcomes of surgical and conservative treatment of type III acromioclavicular joint injury. J Shoulder Elbow Surg 15:300–305. doi:10.1016/j.jse.2005.10.006 PubMedCrossRef

Ceccarelli E, Bondi R, Alviti F, Garofalo R, Miulli F, Padua R (2008) Treatment of acute grade III acromioclavicular dislocation: a lack of evidence. J Orthop Traumatol 9:105–108. doi:10.1007/s10195-008-0013-7 PubMedCrossRef

Colegate-Stone T, Allom R, Singh R, Elias DA, Standring S, Sinha J (2010) Classification of the morphology of the acromioclavicular joint using cadaveric and radiological analysis. J Bone Joint Surg Br 92-B:743–746. doi:10.1302/0301-620X.92B5.22876 CrossRef

Debski R, Parsons IM, Fenwick J, Vangura A (2000) Ligament mechanics during three degree-of-freedom motion at the acromioclavicular joint. Ann Biomed Eng 28:612–618. doi:10.1114/1.1304848 PubMedCrossRef

Fraser-Moodie JA, Shortt NL, Robinson CM (2008) Injuries to the acromioclavicular joint. J Bone Joint Surg Br 90-B:697–707. doi:10.1302/0301-620X.90B6.20704 CrossRef

Fukuda K, Craig EV, An KN, Cofield RH, Chao EY (1986) Biomechanical study of the ligamentous system of the acromioclavicular joint. J Bone Joint Surg Am 68-A:434–440

Gstettner C, Tauber M, Hitzl W, Resch H (2008) Rockwood type III acromioclavicular dislocation: surgical versus conservative treatment. J Shoulder Elbow Surg 17:220–225. doi:10.1016/j.jse.2007.07.017 PubMedCrossRef

10.

Heers G, Hedtmann A (2005) Correlation of ultrasonographic findings to Tossy’s and Rockwood’s classification of acromioclavicular joint injuries. Ultrasound Med Biol 31:725–732. doi:10.1016/j.ultrasmedbio.2005.03.002 PubMedCrossRef

11.

Lee M, Chebli C, Mounce D, Bertelsen A, Richardson M, Matseniii F (2008) Intramedullary reaming for press-fit fixation of a humeral component removes cortical bone asymmetrically. J Shoulder Elbow Surg 17:150–155. doi:10.1016/j.jse.2007.03.032 PubMedCrossRef

12.

Mikek M (2008) Long-term shoulder function after type I and II acromioclavicular joint disruption. Am J Sports Med 36:2147–2150. doi:10.1177/0363546508319047 PubMedCrossRef

13.

Renfree KJ, Wright TW (2003) Anatomy and biomechanics of the acromioclavicular and sternoclavicular joints. Clin Sports Med 22:219–237PubMedCrossRef

14.

Rockwood C, Matsen F, Wirth M, Lippitt S (2009) The shoulder: acromioclavicular traumatic disorder, 4th edn. Saunders Elsevier, Philadelphia

15.

Salter EG, Nasca RJ, Shelley BS (2007) Anatomical observations on the acromioclavicular joint and supporting ligaments. Am J Sports Med 15:199–206. doi:10.1177/036354658701500301 CrossRef

16.

Simovitch R, Sanders B, Ozbaydar M, Lavery K, Warner JJP (2009) Acromioclavicular joint injuries: diagnosis and management. J Am Acad Orthop Surg 17:207–219PubMed

17.

Sluming VA (1995) A comparison of the methods of distraction for stress examination of the acromioclavicular joint. Br J Radiol 68:1181–1184. doi:10.1259/0007-1285-68-815-1181 PubMedCrossRef

18.

Tamaoki MJS, Belloti JC, Lenza M, Matsumoto MH, Dos Gomes Santos JB, Faloppa F (2010) Surgical versus conservative interventions for treating acromioclavicular dislocation of the shoulder in adults. Cochrane Database Syst Rev 4(8):CD007429. doi:10.1002/14651858.CD007429.pub2

19.

Tauber M, Koller H, Hitzl W, Resch H (2010) Dynamic radiologic evaluation of horizontal instability in acute acromioclavicular joint dislocations. Am J Sports Med 38:1188–1195. doi:10.1177/0363546510361951 PubMedCrossRef

20.

Zanca P (1971) Shoulder pain: involvement of the acromio-clavicular joint (analysis of 1,000 cases). Am J Roentgenol 112:493–506

Titel: Measure of horizontal and vertical displacement of the acromioclavicular joint after cutting ligament using X-ray and opto-electronic system
verfasst von: Goulven Rochcongar
Sébastien Emily
Benoit Lebel
Vincent Pineau
Gilles Burdin
Christophe Hulet
Publikationsdatum: 01.09.2012
Verlag: Springer-Verlag
Erschienen in: Surgical and Radiologic Anatomy / Ausgabe 7/2012
Print ISSN: 0930-1038
Elektronische ISSN: 1279-8517
DOI: https://doi.org/10.1007/s00276-012-0953-8

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Measure of horizontal and vertical displacement of the acromioclavicular joint after cutting ligament using X-ray and opto-electronic system