[Treatment of acute AC joint dislocation by transosseal acromioclavicular and coracoclavicular fiberwire cerclage]. / Versorgung der Schultereckgelenksprengung mittels akromioklavikulärer und korakoklavikulärer FiberWire-Cerclage.

AIM: Many different procedures are used for the operative treatment of acute AC joint dislocations type Rockwood III - VI. We discuss the clinical results for an exact anatomical reconstruction of the AC-joint by transosseal acromioclavicular and coracoclavicular FiberWire cerclage. METHOD: 56 patients with acute AC joint dislocations type Rockwood III and V underwent operative treatment, using an exact anatomical reconstruction of the AC joint by transosseal acromioclavicular and coracoclavicular FiberWire cerclage. A clinical and radiological follow-up examination was performed. Clinical complications, objective results, radiological results, Constant and Rowe scores were evaluated. RESULTS: 43 patients could be examined on average 15.4 months after surgery. 24 patients (56 %) showed radiological signs of ossification of the acromioclavicular and coracoclavicular ligaments. Minimal postoperative clavicular displacement was observed in 14 patients (33 %). 2 patients (5 %) needed a second surgery due to complications, in one case because of reduction in the range of motion, in the other case due to abacterial inflammation. The advantage of this type of surgery is a minimal rate of complications and a good objective result with a high Constant score of 94 and Rowe score of 93, without the need for a second surgery. CONCLUSION: This procedure for an exact anatomic AC joint reconstruction shows good objective results with a high Constant and Rowe scores for shoulder function. Postoperative ossifications of the AC joint ligaments are common, but seem to have no influence on the clinical results.

Assignment of the nonexchanging protons of the alpha-spectrin SH3 domain by two- and three-dimensional 1H-13C solid-state magic-angle spinning NMR and comparison of solution and solid-state proton chemical shifts.

The assignment of nonexchanging protons of a small microcrystalline protein, the alpha-spectrin SH3 domain (7.2 kDa, 62 residues), was achieved by means of three-dimensional (3D) heteronuclear (1H-13C-13C) magic-angle spinning (MAS) NMR dipolar correlation spectroscopy. With the favorable combination of a high B(0)-field, a moderately high spinning frequency, and frequency-switched Lee-Goldburg irradiation applied during 1H evolution, a proton linewidth < or =0.5 ppm at 17.6 Tesla was achieved for the particular protein preparation used. A comparison of the solid-state 1H chemical shifts with the shifts found in solution shows a remarkable similarity, which reflects the identical protein structures in solution and in the solid. Significant differences between the MAS solid- and liquid-state 1H chemical shifts are only observed for residues that are located at the surface of the protein and that exhibit contacts between different SH3 molecules. In two cases, aromatic residues of neighboring SH3 molecules induce pronounced upfield ring-current shifts for protons in the contact area.