Subject(s)
Fracture Fixation/adverse effects , Fractures, Ununited/surgery , Humeral Fractures/surgery , Jugular Veins/pathology , Postoperative Complications , Venous Thrombosis/etiology , Anticoagulants/therapeutic use , Bone Nails , Bone Transplantation , Heparin/therapeutic use , Humans , Internal Fixators , Male , Middle Aged , Warfarin/therapeutic useABSTRACT
As the techniques and instrumentation for shoulder arthroscopy continue to improve and evolve, its role in the treatment of anterior shoulder instability progresses also. With more surgeons becoming familiar with these advancements and techniques, arthroscopic stabilization results continue to improve and help arthroscopy become the "preferred method" for the treatment of shoulder instability. Adjunct procedures such as closure of the rotator interval also are helping to improve our arthroscopic results and are an important improvement in our understanding of the pathoanatomy of shoulder instability repairs.
Subject(s)
Arthroscopy/methods , Joint Instability/surgery , Rotator Cuff Injuries , Rotator Cuff/surgery , Shoulder Joint , Female , Follow-Up Studies , Humans , Injury Severity Score , Joint Instability/diagnosis , Male , Minimally Invasive Surgical Procedures/methods , Pain Measurement , Physical Examination , Range of Motion, Articular/physiology , Recovery of Function , Shoulder Pain/diagnosis , Shoulder Pain/etiology , Treatment OutcomeABSTRACT
Injuries to the acromioclavicular joint are common. For selected injuries, operative reconstruction is recommended. The purpose of the current study was to compare three reconstruction procedures: (1) nine strands of woven polydioxanonsulphate (PDS II) suture passed through the clavicle and around the coracoid; (2) procedure No. 1 with 50% of the coracoacromioclavicular ligament placed through 2 clavicular drill holes; (3) No. 5 Merselene tape passed through 2 drill holes in the clavicle and acromion, with 50% of the coracoacromial ligament transferred to the clavicle. Fourteen fresh frozen human shoulders were tested using a 6 degree-of-freedom testing device. The intact shoulder showed significantly less displacement than any of the reconstructions. Merselene tape plus ligament showed the largest displacement, and PDS II braid plus ligament showed the least displacement. None of the procedures reconstituted acromioclavicular joint stiffness to intact state levels, though improved acromioclavicular joint stiffness was noted with a PDS braid plus ligament.
