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Journal articles on the topic 'Acromioclavicular joint disruption'

Author: Grafiati

Published: 5 June 2025

Last updated: 9 July 2025

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1

Mikek, Martin. "Long-Term Shoulder Function after Type I and II Acromioclavicular Joint Disruption." American Journal of Sports Medicine 36, no. 11 (2008): 2147–50. http://dx.doi.org/10.1177/0363546508319047.

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Background Acromioclavicular joint separations are very common lesions, with the majority falling into Rockwood classification type I and II. It is generally agreed that conservative treatment of these injuries leads to good functional results, although there are some studies that suggest these injuries are associated with a high incidence of persistent symptoms. Hypothesis Type I and II acromioclavicular joint disruption significantly impairs long-term shoulder function. Study Design Case series; Level of evidence, 4. Methods The shoulder function of 23 patients who were treated for type I or II acromioclavicular joint disruption was evaluated at a mean of 10.2 years after injury. The objective and subjective measures of the injured shoulder were assessed using Constant, University of California-Los Angeles Shoulder Scale, and Simple Shoulder Test scores and were compared with results of the uninjured shoulder. Results At an average follow-up of 10.2 years, 12 of 23 patients (52%) reported at least occasional acromioclavicular joint symptoms. The average Constant score for the injured shoulder was 70.5 and 86.8 for the uninjured shoulder ( P < .001). The average University of California-Los Angeles Shoulder Scale score for the injured shoulder was 24.1 and 29.2 for the uninjured shoulder ( P < .001). The average Simple Shoulder Test value for the injured shoulder was 9.7 and 10.9 for the uninjured shoulder ( P < .002). The extent of acromioclavicular joint disruption and acromioclavicular joint width did not have any statistically significant influence on the shoulder functional scores. Conclusion Type I and II acromioclavicular joint disruptions impair long-term shoulder function in about half of patients 10 years after injury.

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2

Meignanaguru, Muthusaravanakumar, Yogadeepan Dhakshinamurthi, Deepak Srinivasan, and Ganesh Ramesh Shetty. "Mid-shaft Clavicle Fracture with Disguised Ipsilateral Type IV Acromioclavicular Joint Dislocation – A Rare Case Report." Journal of Orthopaedic Case Reports 14, no. 9 (2024): 19–23. http://dx.doi.org/10.13107/jocr.2024.v14.i09.4714.

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Introduction: Clavicle fractures and acromioclavicular (AC) joint disruptions are very common injuries. However, both injuries occurring simultaneously are very rare entities. Case Report: In this article, we report a case of 21-year-old gentleman with a history of road traffic accident with a right mid-shaft clavicle fracture. We planned for the right clavicle plating. Intraoperatively incidentally, we found that the patient is having type 4 rockwood AC joint disruption with complete posterior displacement and gross instability. We repaired it after plating the clavicle using Ethibond with intraosseous sutures and augmented with trans acromion k wire. Later, k wire was removed, and the patient regained full range of motion shoulder after subsequent follow-up and physiotherapy. Conclusion: Clavicle fractures with ipsilateral AC joint disruptions are very rare. Diagnosing the AC joint disruption and appropriate management is very essential to regain the shoulder function and outcome. Keywords: Acromioclavicular joint, clavicle, Rockwood classification,Ethibond,K wire.

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3

Ravikanth, Kolluri, D. Agape Bliss, and Rao Vavilala Abhilash. "A Study on the Impact of Suture Anchor Fixation on Functional Outcomes in Patients with Acromioclavicular Joint Disruption." International Journal of Pharmaceutical and Clinical Research 15, no. 8 (2023): 1691–95. https://doi.org/10.5281/zenodo.11529131.

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<strong>Background:</strong> The Acromioclavicular (AC) joint is a movable joint stabilized by a combination of both active muscular elements and static ligamentous structures. Typically, non-surgical approaches are favoured for Rockwood type 1 and 2 AC joint disruptions, while surgical intervention is recommended for Rockwood types 3, 4, 5, and 6. However, the optimal surgical procedure for managing AC joint disruption remains a topic of ongoing debate, with the continual evolution of newer techniques. <strong>Methods:</strong> In our study, we investigated 25 patients who underwent AC joint reconstruction using the suture anchor technique. Patients were assessed before the surgery and during post-operative follow-up using serial radiography. Functional evaluation was performed utilizing the Constant Murley score. <strong>Results:</strong> The results showed excellent functional outcomes in 72% of patients, good outcomes in 16% of patients, fair outcomes in 8% of patients, and poor outcomes in 4% of patients. Utilizing the suture anchor technique for AC joint reconstruction proves to be a relatively straightforward approach, resulting in positive functional outcomes and pain relief. These outcomes significantly contribute to an enhanced quality of life for patients. <strong>Conclusion:</strong> suture anchors prove to be an effective approach for patients experiencing acute acromioclavicular joint dislocation, offering a successful reconstruction of both coracoclavicular and acromioclavicular joints. This technique stands as a reliable and efficient method for surgically managing acromioclavicular injuries.    

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4

Braun, Sepp, Andreas B. Imhoff, and Frank Martetschlaeger. "Primary Fixation of Acromioclavicular Joint Disruption." Operative Techniques in Sports Medicine 22, no. 3 (2014): 221–26. http://dx.doi.org/10.1053/j.otsm.2014.03.005.

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5

Shukla, Manish, Naveen Kumar Singh, Alok Dwivedi, and D. C. Srivastava. "Functional Outcome of Operative Technique of Acromioclavicular Joint Reconstruction using Double Endobutton." International Journal of Pharmaceutical and Clinical Research 16, no. 11 (2024): 1554–59. https://doi.org/10.5281/zenodo.14495956.

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The acromioclavicular (AC) joint function as a strut to help with movement of the scapula resulting in a greater degree of arm rotation. There are multiple modalities to treat AC joint disruption in patients. Both conservative and surgical management are possible and surgeon must choose the most appropriate management modality according to biological age, functional demand and type of lesion. This study aimed to evaluate the functional outcome of the double endobutton technique used to treat acromioclavicular (AC) dislocation. In this prospective study, 30 patients are treated for complete acromioclavicular (AC) joint disruption and their functional outcome are measured using Constant score and DASH score. Among 30 patients, 3 (10.00%) showed excellent functional outcome, 18 patients (60.00%) showed good outcome 8 patients (26.67%) showed fair outcome and only 1 patients (3.33%) showed poor functional outcome.    

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6

Baren, James P., Emma Rowbotham, and Philip Robinson. "Acromioclavicular Joint Injury and Repair." Seminars in Musculoskeletal Radiology 26, no. 05 (2022): 597–610. http://dx.doi.org/10.1055/s-0042-1750726.

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AbstractThe acromioclavicular (AC) joint is commonly injured in athletes participating in contact and overhead throwing sports. Injuries range from simple sprains to complete ligamentous disruption, and they are classified by the established Rockwood grading system. High-grade injuries are associated with fractures around the AC joint and disruption of the superior shoulder suspensory complex, a ring of osseous and ligamentous structures at the superior aspect of the shoulder. Radiographs are the mainstay of imaging of the AC joint, with magnetic resonance imaging reserved for high-grade injuries to aid classification and plan surgical management. Low-grade AC joint injuries tend to be managed conservatively, but a wide range of surgical procedures have been described for higher grade injuries and fractures around the AC joint. This review illustrates the anatomy of the AC joint and surrounding structures, the imaging features of AC joint injury, and the most commonly performed methods of reconstruction and their complications.

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7

Dimakopoulos, Panayotis, and Andreas Panagopoulos. "Functional Coracoclavicular Stabilization for Acute Acromioclavicular Joint Disruption." Orthopedics 30, no. 2 (2007): 103–8. http://dx.doi.org/10.3928/01477447-20070201-08.

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8

Jambukeswaran, Dr P. S. T. "The Functional Outcome of Management of Acute Acromioclavicular Joint Disruption Using Tension Band Wiring." Journal of Medical Science And clinical Research 04, no. 11 (2016): 13923–28. http://dx.doi.org/10.18535/jmscr/v4i11.68.

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9

Dimakopoulos, Panayotis, Andreas Panagopoulos, Spyros A. Syggelos, Elias Panagiotopoulos, and Elias Lambiris. "Double-Loop Suture Repair for Acute Acromioclavicular Joint Disruption." American Journal of Sports Medicine 34, no. 7 (2006): 1112–19. http://dx.doi.org/10.1177/0363546505284187.

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10

Sidharta, Made Tusan, I. Gusti Ngurah Wien Aryana, and I. B. Arimbawa. "Functional outcome following coracoclavicular ligament reconstruction using a gracilis tendon graft for acute type III acromioclavicular dislocation: a case report." International Journal of Research in Medical Sciences 6, no. 8 (2018): 2836. http://dx.doi.org/10.18203/2320-6012.ijrms20183280.

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The acromioclavicular joint is stabilized by two ligaments: the acromioclavicular ligaments and coracoclavicular ligaments. AC joint dislocations account for 9% to 10% of all shoulder injuries. Tossy and Allman classified acromioclavicular dislocations into three types (I, II and III). This classification was modified by Rockwood (types IV, V, and VI). Type I and II dislocations are treated conservatively. Surgery is indicated for certain Rockwood type III and for all type IV, V, and VI injuries. A 45 years old man yoga trainer presented to our emergency department with a chief complaint of pain over his left shoulder after had traffic accident 3 hours prior to admission. Physical examination revealed left lateral clavicular end prominent and tenderness over the left shoulder with limited range of motion due to pain. A Zanca view X-Ray of left shoulder was performed and revealed dislocation of acromioclavicular joint. The patient was diagnosed with suspect Left AC joint disruption grade III. We performed coracoclavicular ligament reconstruction using a gracilis tendon graft 2 days after the accident. Before the surgery, constant score of the patient left shoulder was 25 (Fair). The constant score measured was 63 after 10 month follow up. Coracoclavicular ligament reconstruction with an autogenous gracilis tendon graft was feasible and safe in physically active patients with acute type-III acromioclavicular joint dislocation.

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11

Elshahhat, Amr, and Moheib Sayed Ahmed. "Retraction Notice - Hong Kong Journal of Orthopaedic Research." Hong Kong Journal of Orthopaedic Research 6, no. 2 (2023): 1. http://dx.doi.org/10.37515/ortho.8231.6201.

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The following article is being withdrawn. Amr Elshahhat, Moheib Sayed Ahmed. Dual fixation for coracoid fracture with acute acromioclavicular joint disruption: A case series. Hong Kong Journal of Orthopaedic Research, 2022;5(3):32-37. DOI: 10.37515/ortho.8231.5301

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12

Kulkarni, Dr Raju H., and Dr Sharan Chennur. "Functional outcome of acromioclavicular joint disruption treated using anchor sutures." International Journal of Orthopaedics Sciences 7, no. 4 (2021): 696–99. http://dx.doi.org/10.22271/ortho.2021.v7.i4j.2954.

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13

Oki, Satoshi, Noboru Matsumura, Wataru Iwamoto, et al. "The Function of the Acromioclavicular and Coracoclavicular Ligaments in Shoulder Motion." American Journal of Sports Medicine 40, no. 11 (2012): 2617–26. http://dx.doi.org/10.1177/0363546512458571.

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Background: Scapulothoracic dyskinesis is an important consequence of acromioclavicular joint dislocations. However, no reports have described changes in 3-dimensional motions of the scapula and clavicle with respect to the thorax caused by acromioclavicular joint dislocation. Hypothesis: Sectioning of the acromioclavicular (AC) and coracoclavicular (CC) ligaments affects scapular and clavicular motion in a whole-cadaver model. Study Design: Controlled laboratory study. Methods: We evaluated shoulder girdle motion (scapula, clavicle, and humerus) relative to the thorax of 14 shoulders from 8 whole cadavers after sequential sectioning of the AC and CC ligaments (trapezoid and conoid ligaments). An electromagnetic tracking device measured 3-dimensional kinematics of the scapula and clavicle during humerothoracic elevation in the coronal and sagittal planes and adduction in the horizontal plane. Results: Sectioning of the AC ligament increased clavicular retraction during sagittal plane elevation and horizontal plane adduction. Sectioning of the trapezoid ligament decreased scapular external rotation during sagittal plane elevation and horizontal plane adduction. Sectioning of the conoid ligament decreased scapular posterior tilting during sagittal plane elevation and horizontal plane adduction. Acromioclavicular and CC ligament sectioning also delayed clavicular posterior rotation and increased clavicular upward rotation during coronal plane elevation. Conclusion: Our study revealed that AC and CC ligament disruption affected in vitro shoulder girdle kinematics in the whole-cadaver model. Clinical Relevance: The results of this cadaveric study revealed that AC and CC ligament disruption could cause dyskinesis of the scapula and clavicle. The kinematic changes could be a potential source of pain and dysfunction in the shoulder with AC joint dislocation, and therefore surgical reconstruction may be indicated in certain patients.

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14

Chaudhary, Deepak, Vineet Jain, Deepak Joshi, Jitesh Kumar Jain, Ankit Goyal, and Nitin Mehta. "Arthroscopic Fixation for Acute Acromioclavicular Joint Disruption Using the TightRope Device." Journal of Orthopaedic Surgery 23, no. 3 (2015): 309–14. http://dx.doi.org/10.1177/230949901502300310.

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15

Tatiana, Tumbaco Tumbaco, Wilson Martinez Vizuete, Tumbaco Tumbaco Angélica María, and Felipe Jiménez Pinto. "Inestabilidad de la cintura escapular secundario a fractura de acromion asociada a luxación acromioclavicular. A propósito de un caso. Hospital Luis Vernaza." Espirales Revista Multidisciplinaria de investigación 3, no. 27 (2019): 163. http://dx.doi.org/10.31876/er.v3i27.563.

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Introduction The superior suspensory complex (SSSC) described by Goss, is a ring composed of the glenoid, the coracoid process, the coracoclavicular ligaments, the distal clavicle, the acromioclavicular joint and the acromial process. A double disruption of the upper suspensory complex of the shoulder produces an instability between the complex of the scapular waist and the axial skeleton, called "floating shoulder". Objective. It establishes the importance of the study of cases concerning the instability of the shoulder girdle Materials and methods Here is shown the case of a patient with double disruption of the SSSC, Results for displaced fracture of acromion associated with acromioclavicular dislocation, treated surgically with satisfactory results. Discussion Although surgical indications have been reported, the fixation techniques of these fractures is limited. Conclusions We present this case that is not frequent in our professional practice.

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16

Mohamed, Mohamed Morsy, and Osama M. Essawy. "Reconstruction of Conoid, Trapezoid and Acromioclavicular Ligaments in Acute Traumatic Disruption of Acromioclavicular Joint Using Semitendinosus Graft." Egyptian Orthopaedic Journal 60, no. 1 (2025): 9–14. https://doi.org/10.21608/eoj.2025.419267.

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17

Adhikari, Vijayendra, Prasamsha Sitaula, Sumi Singh, et al. "Functional Outcome of Acromioclavicular joint dislocation Type III injuries treated with Hook Plate." Nepal Medical College Journal 26, no. 3 (2024): 247–50. http://dx.doi.org/10.3126/nmcj.v26i3.69887.

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The acromioclavicular joint (AC) dislocation is a complex injury due to the disruption of ligaments and joints, leading to instability and pain. Rockwood type III injuries remain controversial, so clinical evaluation should be taken into consideration before deciding the treatment modalities. The study aimed to evaluate the functional outcome of AC joint dislocation type III injuries treated with a hook plate. A total of 30 patients with AC Joint Dislocation Type III injuries were treated with open reduction and fixation with hook plate during a period of 18 months. The functional outcome was evaluated using constant murley score, the mean score of which was 82 (58-96). There were 7 (23.33%) cases of plate impingement and the symptoms was improved after plate removal. The hook plate is a good fixation device for the treatment of AC joint dislocation -Rockwood type III injuries with minimal complications, as it is a simple procedure, with good functional outcome, without ligamentous procedure and the only drawback is second surgery for implant removal.

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18

Elshahhat, Amr, and Moheib Sayed Ahmed. "Dual fixation for coracoid fracture with acute acromioclavicular joint disruption: A case series." Hong Kong Journal of Orthopaedic Research 5, no. 3 (2022): 32–37. http://dx.doi.org/10.37515/ortho.8231.5301.

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Introduction: Management of concomitant coracoid fracture with acute acromioclavicular joint disruption has been a matter of debate. The coracoid component is not always radiographically recognized; thus, this combined orthopedic injury is not often common. Management options varied from conservative to surgical management with single or dual fixation strategy. This study aimed at outcome evaluation of clavicular hook plate with coracoid screw fixation in athletics and patients with high-demand activities for at least one year follow-up. Material and methods: Included patients underwent fixation through clavicular hook plate and coracoid screw. The hook plate was removed after an average period of 16.1 weeks, rehabilitation program was followed. Patients were subjected at final follow-up visit to clinical assessment via ROMs, constant, and ASES scores. Besides, radiological judgement of acromioclavicular joint reduction as per CCD and CCD ratio. Results: The average ASES Scores were 39.1±14.6, 67.4±11.5, and 86.7±5.7 at 3, 6, and 12 months, respectively with a statistically significant improvement in between (P-value <0.001). The mean active shoulder abduction and forward elevation ROMs were 156.4°±12.8° and 171.4°±6.3°. The average CCD was 9.04±0.9 mm (7.6-10.2 mm), and the mean CCD ratio was 1.07±0.03% (1.01-1.11%). Conclusion: Dual fixation via hook plate and coracoid screw without CCL reconstruction provides a stable fixation construct with considerable functional and radiological outcome in high demand patients with acute traumatic ACJ disruption combined with coracoid fracture. Study Design: Case series study.

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19

AS, Rao, Raju LVSN, and Banda NK. "Segmental clavicle fracture with acromioclavicular joint disruption: Report of a rare case." Journal of Medical and Scientific Research 8, no. 1 (2020): 25–28. http://dx.doi.org/10.17727/jmsr.2020/8-4.

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20

Wright, T. W. "Long-Term Shoulder Function After Type I and II Acromioclavicular Joint Disruption." Yearbook of Hand and Upper Limb Surgery 2009 (January 2009): 3–4. http://dx.doi.org/10.1016/s1551-7977(09)79258-1.

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21

Chernchujit, Bancha, Thomas Tischer, and Andreas B. Imhoff. "Arthroscopic reconstruction of the acromioclavicular joint disruption: surgical technique and preliminary results." Archives of Orthopaedic and Trauma Surgery 126, no. 9 (2005): 575–81. http://dx.doi.org/10.1007/s00402-005-0073-6.

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22

Fahmy, Fahmy Samir, Hossam Fathi, and Mohammad ElAttar. "Clinical outcomes of arthroscopic assissted fixation of acute high grade acromioclavicular joint disruption." Journal of Orthopaedics 16, no. 2 (2019): 133–36. http://dx.doi.org/10.1016/j.jor.2019.02.005.

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23

Elshahhat, Amr, and Moheib S. Ahmed. "Dual fixation for coracoid fracture with acute acromioclavicular joint disruption: a case series." Egyptian Orthopaedic Journal 59, no. 1 (2024): 24–31. http://dx.doi.org/10.4103/eoj.eoj_157_23.

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Abstract Introduction The management of acute disruption of the acromioclavicular joint (ACJ) in conjunction with a concomitant coracoid fracture has been discussed. This combined orthopedic injury is uncommon because radiographs alone may not always be enough to identify the coracoid component clearly. There are different options for management, ranging from nonsurgical, single, or double fixation strategy. The purpose of this study was to evaluate the results of a clavicular hook plate combined with a coracoid screw fixation in patients who engage in high-demand activities and athletes over a minimum of a year of follow-up. Patients and methods Following the dual fixation strategy, seven patients were followed clinically and radiologically with a mean follow-up 16 weeks, through which a rehabilitation program was adhered to. The range of motion around the shoulder, American Shoulder & Elbow Surgeons, and constant scores were utilized to evaluate patients clinically during their last follow-up visit. Furthermore, radiological assessment of the reduction of the ACJ according to coracoclavicular distance (CCD) and CCD ratio. Results The findings in this study showed a statistically significant improvement between the 3, 6, and 12-month American Shoulder & Elbow Surgeons scores, which were 39.1 ± 14, 67.4 ± 1, and 86.7 ± 5, respectively (P<0.001). The mean range of motions for active shoulder abduction and forward elevation was 171.4 ± 6.3° and 156.4 ± 12.8°, respectively. 9 ± 0.9 mm was the mean CCD, and 1.07% was the mean CCD ratio. Conclusion A stable fixation construct with significant functionality can be successfully achieved through the dual fixation strategy using a coracoid screw and hook plate with no coracoclavicular ligament reconstruction in the treatment of concomitant coracoid fracture and acute ACJ injuries in athletes and high-demand patients.

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Wignadasan, Warran, Ossama Al-Obaedi, Alastair Chambers, Marcus Lee, Kannan Rajesparan, and Abbas Rashid. "Concomitant coracoid base fracture and acromioclavicular joint disruption: A series of patients treated with a clavicle hook plate and review of the literature." Journal of Orthopaedic Surgery 30, no. 3 (2022): 102255362211398. http://dx.doi.org/10.1177/10225536221139888.

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Introduction Concomitant acromioclavicular joint (ACJ) disruptions with coracoid base fractures are rare high energy injuries. The management of these injuries can be challenging. The aim of this study is to assess the functional and radiographic outcomes of a retrospective case series of patients presenting with concomitant ACJ and coracoid base injuries managed with a clavicle hook plate with subsequent hardware removal at a later stage. Methods Six patients were identified for inclusion in the study. Radiographic and clinical data were available which allowed for collection of demographic information as well as classification of the fractures. Telephone consultation with patients allowed for collection of functional scores which included the Oxford shoulder score (OSS), QuickDASH (Q-DASH), Euroqol-5 Dimension (EQ-5D) and the SF-12 score. Results All patients were male with a mean age of 39.8 years and a median follow-up period of 34 months. All patients underwent a successful operative procedure with a median time to union of 3.75 months. Good functional outcomes were reported by all patients: mean OSS 45.0, mean Q-DASH 4.8, mean EQ-VAS 82.8 and encouraging SF-12 scores (mean PCS 56.0, mean MCS 56.4). Conclusion The use of a lateral clavicle hook plate can achieve good healing and functional outcomes when managing patients with acromioclavicular joint disruptions associated with a coracoid base fracture.

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C, Yashavantha Kumar, P. Rahul, Srinivas B S Kambhampati, and Singh Vanchit. "Arthroscopic reconstruction of acute acromioclavicular joint disruption using dog-bone button construct: A prospective study." Journal of Arthroscopy and Joint Surgery 7, no. 3 (2020): 151–56. http://dx.doi.org/10.1016/j.jajs.2020.05.004.

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Wood, T., P. Rosell, and J. Clasper. "Preliminary Results of the 'Surgiligtm' Synthetic Ligament in the Management of Chronic Acromioclavicular Joint Disruption." Journal of the Royal Army Medical Corps 155, no. 3 (2009): 191–93. http://dx.doi.org/10.1136/jramc-155-03-03.

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Pill, Stephan G., Lane Rush, John Arvesen, et al. "Systematic review of the treatment of acromioclavicular joint disruption comparing number of tunnels and graft type." Journal of Shoulder and Elbow Surgery 29, no. 7 (2020): S92—S100. http://dx.doi.org/10.1016/j.jse.2020.04.008.

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Lucas, João, Miguel Rocha, Rui Matos, et al. "Acromioclavicular Joint Dislocation in a 16-Year-Old High-Level Basketball Player – Case Report of a Rare Injury in Children." SVOA Orthopaedics 5, no. 2 (2025): 51–55. https://doi.org/10.58624/svoaor.2025.05.009.

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Acromioclavicular joint (ACJ) injuries are uncommon in adolescents because their ligaments are particularly strong at this age. Therefore, in an immature skeleton, injuries to the lateral clavicle more likely result in physeal fractures rather than coracoclavicular ligaments disruption. This report presents the case of a 16-year-old male patient, high-level basketball player, who sustained a high-grade ACJ dislocation following sports-related trauma. Clinical examination and imaging confirmed a Rockwood Type V ACJ dislocation. There is no consensus in the literature regarding the optimal treatment for these injuries, however given his young age, activity level, and functional demands, an arthroscopyassisted coracoclavicular (CC) fixation was performed. Postoperatively, the patient followed a structured rehabilitation program, initially involving immobilization followed by progressive physiotherapy

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Mandice, C. Joney, S. Mohan Kumar, and Heber Anandan. "Functional and radiological outcomes of acromioclavicular joint reconstruction in type iii disruption without allograft with synthetic materials." International Journal of Orthopaedics Sciences 3, no. 4l (2017): 836–39. http://dx.doi.org/10.22271/ortho.2017.v3.i4l.113.

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30

Seenappa, Hariprasad, Sakthikesavan Sivanandan, Cecil Fernando, and Harsha Madanamanchi. "Functional outcome for the acromioclavicular joint disruption with or without lateral end clavicle fractures treated with hook plate." Journal of Orthopaedics and Spine 8, no. 2 (2020): 65. http://dx.doi.org/10.4103/joasp.joasp_37_20.

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Zhang, Li-Feng, Bo Yin, Su Hou, Bing Han, and De-fa Huang. "Arthroscopic fixation of acute acromioclavicular joint disruption with TightRope™: Outcome and complications after minimum 2 (2–5) years follow-up." Journal of Orthopaedic Surgery 25, no. 2 (2017): 230949901668449. http://dx.doi.org/10.1177/2309499016684493.

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Jaën, Matthieu, Lydie Sayer, and Paolo Fornaciari. "Triple Disruption of the Superior Shoulder Suspensory Complex: review and Surgical Technique." Journal of Orthopaedic Case Reports 13, no. 6 (2023): 121–26. http://dx.doi.org/10.13107/jocr.2023.v13.i06.3720.

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Introduction: The shoulder girdle is composed of two arches, and these two arches are held together by the superior shoulder suspensory complex (SSSC), a ligamentous complex. Goss’s 1993 description of the SSSC as a ring includes the glenoid, coracoid process, coracoclavicular ligaments, distal clavicle, acromioclavicular joint, and acromion. Goss also noted in a 1996 study that a rupture of the SSSC in two places can result in an unstable lesion. This case report presents an unusual association of fractures involving the coracoid process, acromion, and distal clavicle, which has rarely been reported in the literature. Indeed, a triple lesion of the SSSC is very uncommon and the treatment is still debated. Therefore, we propose a surgical technique which we believe to have provide good results. Case Report: A 54-year-old Caucasian male patient presented with Neer I distal third fracture of the clavicle, a displaced fracture of the acromion, and a fracture of the coracoid process following a left shoulder trauma after an epileptic crisis. The patient underwent surgery and has been followed for 1 year with good clinical and functional outcomes. Conclusion: This case report highlights the complexity of lesions of the SSSC and the importance of determining proper surgical technique based on the type of lesion. It demonstrates that surgery combined with active rehabilitation can lead to good functional outcomes for patients with this type of injury. This report will be of interest to clinicians involved in the treatment of this type of lesion and should add a valuable treatment option for the treatment of triple disruption of the SSSC. Keywords: Shoulder fractures, superior shoulder suspensory complex, surgical technique.

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Bhatia, DeepakN, and RichardS Page. "Surgical treatment of lateral clavicle fractures associated with complete coracoclavicular ligament disruption: Clinico-radiological outcomes of acromioclavicular joint sparing and spanning implants." International Journal of Shoulder Surgery 6, no. 4 (2012): 116. http://dx.doi.org/10.4103/0973-6042.106224.

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Ballal, Dr Madan Mohan, Dr Chidananda KJC, Dr Nagegowda KN, and Dr Muthu Kishore M. "Prospective study of functional outcome in the management of type 3 acromioclavicular joint disruption by suture disc technique augmented with Mersilene tape and distal clavicular resection." International Journal of Orthopaedics Sciences 7, no. 2 (2021): 89–93. http://dx.doi.org/10.22271/ortho.2021.v7.i2b.2615.

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Morioka, Takeshi, Kiyohisa Ogawa, and Masaaki Takahashi. "Avulsion Fracture of the Coracoid Process at the Coracoclavicular Ligament Insertion: A Report of Three Cases." Case Reports in Orthopedics 2016 (2016): 1–5. http://dx.doi.org/10.1155/2016/1836070.

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Avulsion fracture at the site of attachment of the coracoid process of the coracoclavicular ligament (CCL) is extremely rare. We presented three adult cases of this unusual avulsion fracture associated with other injuries. Case 1 was a 25-year-old right-handed male with a left distal clavicular fracture with an avulsion fracture of the coracoid attachment of the CCL; this case was treated surgically and achieved an excellent outcome. Case 2 was a 39-year-old right-handed male with dislocation of the left acromioclavicular joint with two avulsion fractures: one at the posteromedial surface of the coracoid process at the attachment of the conoid ligament and one at the inferior surface of the clavicle at the attachment site of the trapezoid ligament; this case was treated conservatively, and unfavorable symptoms such as dull pain at rest and sharp pain during some daily activities remained. Case 3 was a 41-year-old right-handed female with a right distal clavicular fracture with an avulsion fracture of the coracoid attachment of the conoid ligament; this case was treated conservatively, and the distal clavicular fracture became typical nonunion. These three cases corresponded to type I fractures according to Ogawa’s classification as the firm scapuloclavicular connection was destroyed and also to double disruption of the superior shoulder suspensory complex. We recommend surgical intervention when treating patients with this type of acute or subacute injury, especially in those engaging in heavy lifting or overhead work.

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Rakha, Mohamed I., and Ahmed Toreih. "Arthroscopic-assisted stabilization of distal clavicle fractures with coracoclavicular ligament injury: does it restore anatomy and function?" Egyptian Orthopaedic Journal 58, no. 3 (2023): 214–23. http://dx.doi.org/10.4103/eoj.eoj_10_23.

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Abstract Background Fractures of the lateral-third clavicle are less common than the mid-shaft. However, these lateral thirds are associated with disruption of coracoclavicular (CC) ligaments requiring surgical management for optimal fracture healing and functional outcome. Many surgical techniques have been developed to manage these fractures; however, high failure rates and implant-related complications were reported. This study aims to assess the radiological and functional outcomes of arthroscopic-assisted stabilization of the distal end clavicle in terms of union rate, complications, and shoulder function. Patients and methods A prospective study of 32 patients with distal displaced clavicle fracture combined with CC ligament injury (Neer type IIB, V) who underwent surgery within the first 2 weeks of injury between January 2017 and February 2020. Clinical evaluation was employed postoperatively using the Constant–Murley score. The stability of the acromioclavicular joint in the horizontal and vertical planes was evaluated by the cross-arm test and manual dislocation. Radiological assessment was reviewed by an independent observer who was not a surgical team member at 1 and 2 months postoperatively. Results A series of 32 patients (24 men and eight women) were included. Their mean age was 36 years. Based on the radiological imaging, 20 patients had Neer type-IIB fractures, while 12 showed type-V fractures. Their average union time was 6.12 ± 1.26 weeks (ranged 5–9 weeks), with a mean Constant–Murley score that was 96.1 ± 3.76 (range, 89–100). An average of 6.62 ± 1.82 weeks was needed before returning to prior activities. There were no complications reported. Conclusions Arthroscopic-assisted fixation of the distal end clavicle provides excellent fixation results and restores the native anatomy by reconstructing the torn CC ligament without complications or the need for removal of the implant.

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Li, Fenglong, Yue Li, Yi Lu, Yiming Zhu, and Chunyan Jiang. "Clinical Outcome of a Modified Coracoid Tunnel-Free Coracoclavicular Sling Technique With Remnant Preservation for the Treatment of High-Grade Acromioclavicular Joint Separation: A Report of 48 Cases With 2 to 5 Years of Follow-up." American Journal of Sports Medicine 49, no. 6 (2021): 1612–18. http://dx.doi.org/10.1177/03635465211002149.

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Background: High-grade acromioclavicular (AC) joint separation injuries (Rockwood type IV or V) are surgically indicated because of complete disruption of the AC and coracoclavicular (CC) ligaments, leading to instability and pain. In surgical techniques that require a suspensory system, coracoid tunnel-related complications are not uncommon. Purpose: To report subjective and objective clinical outcomes and complication rates of a modified coracoid tunnel-free CC sling technique combined with CC ligament remnant preservation for a minimum 2-year follow-up. Study Design: Case series; Level of evidence, 4. Methods: Between January 2014 and January 2017, we prospectively enrolled patients who underwent a modified CC sling technique performed by 1 senior surgeon using the AC TightRope System in a coracoid tunnel-free fashion. The CC distance (CCD) and Rockwood AC joint classification were evaluated on radiographs preoperatively, immediately postoperatively, and at the final follow-up. The visual analog pain score, range of motion, American Shoulder and Elbow Surgeons score, Constant-Murley score, and University of California Los Angeles score were recorded preoperatively and at the final follow-up. Results: In total, 48 of 54 patients (88.9%) were included for the evaluation with a mean ± SD follow-up of 39.3 ± 8.9 months (range, 24.7-64.3 months). The CCD was significantly decreased from 22.7 ± 4.2 to 9.8 ± 2.3 mm ( P < .01) immediately after surgery and to 11.2 ± 1.8 mm ( P < .01) at final follow-up. At the final follow-up, the side-to-side difference of CCD was 3.5 ± 0.6 mm. Compared with the preoperative level, all subjective evaluations were significantly improved at the final follow-up. We observed that 4 of the 48 patients (8.3%) had a loss of reduction at the final follow-up, but no pain or instability was documented. Further, no coracoid-related complication or other complications were recorded. Conclusion: The coracoid tunnel-free CC sling technique using the AC TightRope System combined with CC ligament remnant preservation demonstrated significant improvement regarding both clinical and radiological outcomes, with a reduction loss rate of 8.3%. It is a safe method that could achieve satisfactory result without any coracoid drilling-related complications.

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Tuor, Philipp, Michael Dietrich, and Patrick Grüninger. "Surgical management of multiple superior shoulder suspensory complex disruptions involving at least a coracoid fracture and an acromioclavicular dislocation: A report of five cases." SAGE Open Medical Case Reports 11 (January 2023): 2050313X2311667. http://dx.doi.org/10.1177/2050313x231166776.

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A combination of coracoid fracture and acromioclavicular dislocation is rare. Detecting further pathologies that could cause multiple superior shoulder suspensory complex disruptions is mandatory. Literature regarding these injuries and their management is lacking. We report our diagnostic and surgical strategies, and the postoperative outcomes of superior shoulder suspensory complex disruptions. We present five cases, treated from 2011 to 2016, who had >2 disruptions of the superior shoulder suspensory complex, involving at least a coracoid fracture and an acromioclavicular joint dislocation. Surgical reconstruction was performed in all cases. The patients were postoperatively followed up for a year. There were no intraoperative or postoperative complications, and bone union was achieved in all fractures. Furthermore, all patients returned to their pre-surgery activity level and jobs. Thus, we could demonstrate that in multiple superior shoulder suspensory complex disruptions involving a coracoid fracture and an acromioclavicular joint dislocation, surgical treatment leads to a good functional outcome.

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Gupta, Paras, Gagan Kansal, Shekhar Srivastav, and Shekhar Agarwal. "Arthroscopic fixation using TightRope device for acute acromioclavicular joint disruptions." Journal of Arthroscopy and Joint Surgery 3, no. 1 (2016): 7–12. http://dx.doi.org/10.1016/j.jajs.2016.01.002.

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Fialka, C., W. Michlits, P. Stampfl, et al. "Biomechanical Analysis of Different Operative Techniques for Complete Acromioclavicular Joint Disruptions." Osteosynthesis and Trauma Care 13, no. 3 (2005): 154–59. http://dx.doi.org/10.1055/s-2005-836559.

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Athar, MS, Neil Ashwood, Georgios Arealis, Mark Hamlet, and Emma Salt. "Acromioclavicular joint disruptions: A comparison of two surgical approaches ‘hook’ and ‘rope’." Journal of Orthopaedic Surgery 26, no. 1 (2018): 230949901774998. http://dx.doi.org/10.1177/2309499017749984.

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Dussa, Praveen, J. H. Vidya Sagar, Thimma Reddy Yangala, et al. "Biological Reconstruction of Acromioclavicular Joint Ligament Using Semitendinosus Autograft: A Prospective Study on Functional Outcomes and Complications." Journal of Telangana Orthopaedic Surgeons Association 2, no. 1 (2024): 21–25. http://dx.doi.org/10.4103/jtosa.jtosa_9_23.

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Abstract Introduction: The acromioclavicular (AC) joint, a crucial point of shoulder articulation, facilitates overhead and across-the-body arm movements. Athletes, especially those in high-contact or fall-prone sports, frequently experience AC joint injuries. These injuries, based on the Rockwood classification, range from type I to type VI, with treatments varying accordingly. One innovative treatment method reconstructs both ligaments using a semitendinosus autograft, aiming for an anatomical and functional restoration of the joint. This study evaluates the outcomes and complications of this method. Methodology: Study design: A prospective study from January 2021 to July 2022. Data source: Patients with Rockwood type III to VI AC joint ligament disruptions treated at Osmania General Hospital. Sample size: 14 patients. Surgical Technique for Acromioclavicular Ligament Reconstruction: Detailed steps encompassing patient positioning, graft harvesting and preparation, surgical approach, graft fixation, and postoperative care. Results: A total of 14 patients with AC disruptions (12 men and 2 women) treated with semitendinosus reconstruction were followed up for 24 months. Out of 14, 13 were Rockwood type III and 1 was type V ACJ dislocations. The mean patient age was 41 years (25–59 years). Functional outcome was assessed according to the constant-Murley score, according to which 7 patients had excellent, 6 had good, and 1 had an adequate outcome. We had only 1 case of surgical site infection leading to delayed rehabilitation leading to loss of abduction. Discussion: AC joint disruptions represent a significant percentage of shoulder injuries, especially among young, active individuals. Conservative treatments are typical for lower-grade injuries, but high-grade injuries often necessitate more invasive approaches. Our study included 14 patients, focusing on a semitendinosus autograft reconstruction. The historical Weaver–Dunn procedure, though once popular, has been phased out due to recurrence and strength issues. Our method, avoiding the controversial coracoid tunnel drilling, has shown promising results with no recorded fractures. Conclusion: The semitendinosus autograft method, with its biological orientation for coracoclavicular ligament reconstruction, presents fewer complications, especially in terms of coracoid fractures and reduction losses.

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M., Chathrapathi Hanuman, Sarfaraz Syed, Madhusudhan Reddy M., and C.V. Vishnuprasad. "Functional Outcome of Surgical Management of RockwoodType III-VI AC Joint Separation Repaired Using Non- Absorbable Ethibond-2." International Journal of Pharmaceutical and Clinical Research 16, no. 5 (2024): 838–47. https://doi.org/10.5281/zenodo.11427807.

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<strong>Background:</strong> Injuries to the acromioclavicular (AC) joint represent a spectrum of soft tissue disruptions that can result in mild, transient pain of the joint to significant displacement, chronic pain, and changes in shoulder biomechanics resulting in long term disability. These injuries most commonly occur in male patients <30 years and are associated with contact sports or athletic activity in which a direct blow to the lateral aspect of the shoulder occurs. Anatomic reconstruction of the native CC ligaments and AC ligaments represents an improved understanding of the biomechanics in this area with the attempt to improve surgical outcomes. Aim of the study is to evaluate the clinical and radiological outcome of coraco-clavicular and acromioclavicular joint reconstruction with non-absorbable Ethibond no. 2 for treatment of Type III – VI AC Joint separation. <strong>Study Design:</strong> Ambispective Case series. <strong>Methodology:</strong> A total of 20 patients attending the causality and OPD of Orthopedics Department at Government Medical College, Kadapa diagnosed with Rockwood Type III-VI AC joint separation were taken for the study after prior well informed written consent. The clinical and functional outcome was assessed with VAS Score and Constant & Murley Score while the radiological outcome was assessed using plain radiograph. <strong>Results:</strong> Among the 20 patients who were included in the study, nine, six and three patients sustained Rockwood type V, IV and III injuries respectively. The mean age was 38.8 ± 6.569 (mean ± SD) with a mean follow-up of 12 months. At 12 months follow-up the mean VAS score was 0.65 ± 0.476 and mean Constant Murley Score was 90.75 ± 1.81. Compared to the baseline the clinical scores improved significantly (p<0.05). No Neurovascular complications were encountered in any of the patients who were part of this study. <strong>Conclusion:</strong> In this study AC joint dislocations type III-VI treated with ligament reconstruction by using 2 loops of Ethibond 2 and AC ligament repaired by single loop Ethibond 2 is a reliable method for establishing Antero-posterior and superio-inferior stability of AC joint and results in excellent clinical, radiological and functional outcome.    

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Bottoni, Craig R. "Paper # 143: Clinical Results of a Novel Arthroscopically-Assisted Coracoclavicular Ligament Repair for Chronic Acromioclavicular Joint Disruptions." Arthroscopy: The Journal of Arthroscopic & Related Surgery 27, no. 10 (2011): e162. http://dx.doi.org/10.1016/j.arthro.2011.08.143.

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G, Kamalakannan, Abraham M Antony, and Kamalesh T. "FUNCTIONAL OUTCOME OF ACROMIOCLAVICULAR JOINT DISRUPTION (TYPE 3 AND TYPE 5) MANAGED WITH MODIFIED WEAVER DUNN PROCEDURE WITH SUTURE ANCHORS - A PROSPECTIVE STUDY." INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH, April 1, 2023, 21–23. http://dx.doi.org/10.36106/ijsr/5700872.

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Background: Acromioclavicular joint is an important joint in the shoulder complex as it is involved in various functions like providing connection of upper extremity to the axial skeleton, aids stability during overhead activities and while lifting heavy weight. Injuries to acromioclavicular joint are very common in athletes and to some extent in motor vehicle accidents. The treatment of injuries to the acromioclavicular joints has been controversial for a very long time. This is a prospective study of 30 cases of Ac Materials And Methods: romioclavicular Joint disruption treated by Modied Weaver Dunn Procedure with suture anchors from September 2017 to January 2021 at our Institution and followed for minimum of 12 months. The selected patients were evaluated clinicall, and radiologica Results: lly and after relevant lab investigations were taken for surgery. Patient with Acromioclavicular joint disruption classied as per the Rockwood classication and treated accordingly by surgical treatment by Modied Weaver Dunn Procedure with suture anchors. Early gravity aided range of motion was started after 3 weeks from surgery and active range of motion was deferred until 6-8 weeks and sport activity after 3 months. The postoperative shoulder range of motion and weight lifting ability was excellent. Surgical management of acromioclavicular joint disruption by Modie Conclusion: d Weaver Dunn Procedure with suture anchor will give excellent anatomical reduction, good full range motion and weightlifting ability to the shoulder.

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Fandridis, Emmanouil Μ., Frantzeska Zampeli, and Panagiotis Dimakopoulos. "Arthroscopically Assisted Double-Loop Suture Repair for Acute Acromioclavicular Joint Disruption." Arthroscopy Techniques, April 2022. http://dx.doi.org/10.1016/j.eats.2022.01.013.

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Gupta, Govind Kumar, Subhajit Halder, Sudha Rani, Ratnajeet Chakraborty, Amit Kumar, and Tushar Kumar. "Comparison of Double Endobutton and Clavicular Hook Plate in Acromioclavicular Joint Disruption: A Systematic Review and Meta-analysis." Annals of African Medicine, June 8, 2024. http://dx.doi.org/10.4103/aam.aam_13_24.

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Abstract Background: Acromioclavicular joint (ACJ) disruptions are corrected by surgery either with an endobutton or a hook plate. The results in the long term were found to be similar in many randomized controlled trials. This study aims to conduct a meta-analysis to evaluate the functional outcome and complications of double endo button versus clavicular hook plate (CHP) for ACJ disruption (Rockwood types III–VI). Materials and Methods: Two authors independently searched related articles from electronic databases (PubMed, Google Scholar, MEDLINE, SCOPUS, and Web of Science) till January 26, 2022. The data were extracted from the related articles and analyzed by Stata software. For bias calculation of each study, the Newcastle–Ottawa scale and the RevMan 5.4 software were used. Results: 14 cohort studies, 2 randomized control trial studies, and 1 case–control study including patients were selected in this meta-analysis. The results of our study showed a significantly higher Constant–Murley Score (WMD 5.79, 95% confidence interval [CI] 2.23–9.36), Visual Analog Scale (WMD− 0.63, 95% CI [−0.79, −0.46]) and University of California at Los Angeles shoulder score (UCLA) scale (WMD 3.32, 95% CI [2.87, 3.77]) for double endobutton group. At the same time, some complications like implant failure were more common in the double endobutton group. Conclusion: This meta-analysis shows better functional and clinical outcomes of shoulder joint for the treatment of acromioclavicular joint (ACJ) disruption cases (Rockwood types III–VI) with no need for secondary operation, unlike the CHP. Complications like subacromial erosion, ACJ arthrodesis, and infection rate are higher in the CHP group, whereas the chance of implant failure is higher in the double endobutton group.

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Kumar P., Sudheer, Suman NV., Naveen Kumar S., et al. "Functional Results of Treatment of the Acromioclavicular Joint Dislocations Using Percutaneous Dual-Endo Button Technique." International Journal of Innovative Science and Research Technology (IJISRT), August 17, 2024, 3047–51. http://dx.doi.org/10.38124/ijisrt/ijisrt24jul1584.

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The Percutaneous double endobutton approach is increasingly used for complete acromioclavicular (AC) joint dislocation repair. This abstract summarizes its functional outcomes, emphasizing restored stability, pain relief, improved range of motion, and high rates of return to pre-injury activities. With low complication rates and favorable long-term results reported, the technique proves effective in managing AC joint dislocations, offering patients a reliable path to functional recovery and satisfaction.  Materials This study encompasses 10 cases of complete acromioclavicular joint disruption treated at the Department of Orthopedics, Navodaya Medical College & Hospital, Raichur, from August 2022 to June 2024.  Results In our prospective study spanning 22 months, the average surgical duration was notably shorter compared to alternative procedures. Additionally, we observed a swifter return of patients to their normal activities.  Conclusion Percutaneous fixation for ACJ injuries is a safe and effective treatment. It provides good results for function and appearance. Our study involves a limited number of cases, and further research is needed to establish it as a novel technique.

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Ganda, Janesh, Stephen Roche, and Shaun Scheepers. "Case report: Rare case of a traumatic isolated rupture of the conoid ligament." South African Journal of Sports Medicine 36, no. 1 (2024). http://dx.doi.org/10.17159/2078-516x/2024/v36i1a16854.

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Acromioclavicular (AC) joint injuries can involve disruption of the AC and coracoclavicular ligaments. We report a case in aprofessional rugby player of an isolated disruption of the conoid ligament with no injury to the AC and trapezoid ligaments. A 24-year-old professional rugby player fell onto his outstretched hand, injuring his right shoulder. The differential diagnosis was an AC joint injury, coracoid fracture, stress fracture of the coracoid process, or subtle clavicle fracture, which could not be diagnosed on plain film X-ray. An MRI confirmed an isolated rupture of the conoid ligament. No injury to the AC ligament or trapezoid was identified. Five weeks after the injury, the patient returned to full contact training and match play. This case demonstrates that in AC joint injuries, it is possible that the trapezoid ligament and conoid ligament are not simultaneously disrupted, and management is per a Grade II/III AC joint injury.

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Thiel, Eric, Amar Mutnal, and Gregory J. Gilot. "Surgical Outcome Following Arthroscopic Fixation of Acromioclavicular Joint Disruption With the TightRope Device." Orthopedics, July 7, 2011. http://dx.doi.org/10.3928/01477447-20110526-11.

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