Shoulder separation also called AC ( acromioclavicular ) separation or dislocation of CA is a very common injury usually as a result of a direct force on the tip of the acromion ( scapula) or fall onto an outstretched hand. To better understand this injury , you have to step back and review the anatomy of the shoulder girdle.
The shoulder girdle ( scapula and clavicle ) is actually connected to the body in the joint between the clavicle and sternum (breastbone ) . The shoulder is suspended and supported by many muscles that originate or are inserted into the bones in the shoulder. The shoulder is actually suspended from the clavicle ( collarbone) is held in place by ligaments between the coracoid (shoulder blade) and the clavicle , with the capsule of the AC joint and several muscles around the shoulder.
So if only the capsule of the AC joint is injured, but the ligaments are preserved , is considered a mild shoulder separation and does not cause a big bump or prominence of the clavicle. As the severity of the injury increases, the damage is done - the suspensory ligament rupture scapula - shoulder now falls out of the clavicle , resulting in a rut . With more injuries , the clavicle may also be moved or moved higher , or even pushed down too.
Levels of minor injuries are often treated like any other sprain (think mild ankle sprain, for example) and usually do not require any type of surgery to regain normal use. Levels of serious injuries are usually treated with surgery. The most controversial type of injury is the shoulder type III , where ligaments and capsule rupture AC separation . This is the same injury suffered by quarterback Sam Bradford in the NFL during his final year of collegiate play in Oklahoma. In some patients with a lot of muscle tone or weak muscles are sometimes able to compensate the damage by holding the shoulder girdle reduced while the wounds heal. Unfortunately, for many patients with this injury , the amount of shoulder drop that occurs can not be fully compensated and experience pain and a major breakdown.
Hundreds of surgical procedures have been described for the repair and / or high quality reconstruction of shoulder ligaments separations . The vast majority of these procedures are based on a modification of a surgical procedure called the Weaver- Dunn surgery. This surgery and subsequent amendments involving the transfer of another ligament [ CA ( coracoacromial ) ligament ] to take the place of torn CC ligaments ( acromioclavicular ) . Unfortunately , these methods are limited by the highly variable success rate . CA ( coracoacromial ) ligament is also recognized increasingly important for shoulder ligaments function again. Although the incidence of shoulder ligaments separation is relatively high, the number of surgeons performing the separation of more than 5 companies shoulder ligaments a year is very low - to say that most orthopedic surgeons perform these procedures rarely. Especially for technically advanced procedures , it is very difficult for the surgeon to perform the procedure rarely develop any kind of reliable experience . Add to that the wide range of procedures available , and it is not uncommon for surgeons to treat a different type of reconstruction procedure for each case separately posterior shoulder.
Several major vessels and nerves are also traveling around this area of the shoulder ligaments strap and the latter may be involved in the mechanism of injury , and must be respected in any surgical approach. Other potential complications include:
Collarbone loss reduction ( does not stay in the correct position)
Clavicle or coracoid fracture
infection
painful scar
Deltoid detachment / Keystone
Many patients with this lesion have other injuries ( rotator cuff , labral tear , shoulder ligaments instability , etc) that require treatment , while a reliable arthroscopic approach offers many advantages for both the patient and the surgeon. Our technique offers the following advantages:
Arthroscopic technique offers potentially reduce morbidity , improved aesthetics and the ability to respond at the same time shoulder ligaments pathology .
A tunnel only 4.5 mm in the clavicle and coracoid tunnels instead more or multiple help reduce the risk of subsequent fracture .
Continuous suture loops placed through the coracoid and clavicle provide uniform coracoid graft and clavicle compression . Instead of easing the burden of the graft , creating a concept of strip tension to keep the tension and position of the transplant .
Place the graft in the upper crust of the coracoid accurately reproduces the anatomical location of the native CC ligaments and avoids the possibility of anterior translation of the clavicle over graft around the collarbone .
The risk of injury neurovascular structures within the coracoid is reduced because the coracoid medial dissection is required shoulder ligaments.
The placement of a single well in the clavicle allows 35 mm in both graft limbs to play the course and the role of the trapezoid ligament and conoid anatomical .
No. 7 device Adjustable Loop Loc rocker has an average peak load of 1664.1N with £ 374.1 0mm sliding test phase cyclic loading resulting from the highly desirable probability of graft failure and not at the point of attachment.
The combination of high initial fixation strength of the shoulder ligaments progressive incorporation of the graft to reconstruct the native ligaments offers both a rapid return to function and long-term sustainability .
Suffering from a major shoulder ligaments injury as a high quality separate shoulder ligaments is quite painful , not make things worse by doing your homework and find the best solutions available for you to return to your normal routine as soon as possible shoulder ligaments. In summary, we present a robust and reliable technique for arthroscopic anatomic reconstruction as an option for chronic and acute symptomatic shoulder ligaments high quality and many surgeries and failed to separations shoulder ligaments separations shoulder ligaments.