Journal of shoulder and elbow surgery
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J Shoulder Elbow Surg · Nov 2003
Comparative StudyA cadaveric study examining acromioclavicular joint congruity after different methods of coracoclavicular loop repair.
A basic principle in the treatment of joint injuries is to restore congruity with the hope that restoration may lessen the incidence of late arthritis. The acromioclavicular (AC) joint is frequently injured. Many AC joint injuries are treated nonoperatively; others are treated surgically. ⋯ The techniques only varied by the placement of the drill hole in the clavicle (ie, either posterior, middle, or anterior). The results of this study indicate that as the drill hole moved anteriorly on the clavicle, joint congruity was more closely approached and less anterior displacement of the clavicle occurred. However, none of the methods of coracoclavicular loop fixation restored full AC joint congruity.
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J Shoulder Elbow Surg · Nov 2003
Clinical outcome of the treatment of floating shoulder by osteosynthesis for clavicular fracture alone.
Floating shoulder is an unstable combination of fractures that involve the scapular neck and the ipsilateral midclavicle and require surgical treatment. The clinical outcome of the surgical treatment of floating shoulder for the clavicular fracture alone is reported. ⋯ According to the UCLA score, the mean score was 34.2 points during a mean follow-up period of 57.4 months. In patients with a floating shoulder, it is important to evaluate the severity of fracture displacement and coracoclavicular ligament rupture accurately, and on the basis of this evaluation, an appropriate treatment for both fractures that may lead to a satisfactory clinical outcome can be determined.
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Serratus anterior paralysis can result in winging of the scapula and weakness of arm elevation. The etiology of the condition is injury to the long thoracic nerve. There are many proposed causes of long thoracic nerve injury including acute trauma, Parsonage-Turner syndrome, or viral illness. ⋯ In those in whom nerve function fails to recover, surgical treatment involving pectoralis major transfer may be beneficial. In this study 9 patients underwent pectoralis major transfer with a fascia lata extension graft. The symptoms of most were improved, with correction of the winging and improved movement in the affected shoulder.