Der Unfallchirurg
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Acute or chronic instability and osteoarthritis of the acromioclavicular (ac) joint may cause significant impairment of the shoulder. In this continuing education report, the pathomorphology of acute ac dislocations is described based on the Rockwood classification. Decision making on conservative or surgical treatment is discussed. ⋯ A modified Weaver-Dunn procedure is presented in detail. In any patient with shoulder pain, osteoarthritis of the ac joint has to be taken into consideration. Resection of the lateral clavicle has proved to be effective in these patients.
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Comparative Study
[Polytrauma in cyclists. Incidence, etiology, and injury patterns].
In our region we have noticed an increasing number of cyclists and consequently a rise in bicycle-related accidents in recent years. A large number of our polytraumatized patients are victims of bicycle-related accidents. ⋯ The most frequent and most severe injury was the head injury (94%). Of the 32 polytraumatized cyclists 30 did not wear a helmet. Successful prevention could possibly be practiced if all cyclists wear helmets.
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Comparative Study
[Sensorimotor deficit after capsulolabral reconstruction in chronic instability of the shoulder. A clinical experimental study].
The anterior capsulolabral reconstruction technique described by Jobe is a modified Bankart repair. The capsular shift is performed in a horizontal direction via a subscapularis split approach avoiding any incision of the muscle. Of 43 patients with posttraumatic anterior shoulder instability treated by anterior capsulolabral reconstruction, 35 were examined after 3.7+/-1.4 years, and of these, 29 (82.9%) had no pain; the external rotation deficit was 4.1+/-2.9 degrees. ⋯ This technique was shown to provide good clinical results, but only 69% of the patients were able to return to their prior sporting activity level. This particular problem was addressed by investigating the joint proprioception and the activity of the periarticular muscles. The results confirmed a persistent deficit of proprioception as well as a pathologic EMG pattern after anterior capsulolabral reconstruction, which may explain the problem of incomplete restoration of the function of the shoulder joint.