Acromioclavicular joint separation treated with clavicular hook plate: a study of radiological and functional outcomes.

INTRODUCTION: ACJ separation is a common shoulder injury. A variety of surgical techniques for high-grade ACJ separations have been described. A commonly used technique represents open reduction and fixation by a hook plate. Goal of the present study was to evaluate radiographic and functional outcome in patients with high-grade ACJ separations following surgical treatment with a hook plate before and after surgery as well as after hook plate removal. MATERIALS AND METHODS: Patients undergoing surgery with a hook plate due to traumatic ACJ separation between 2012 and 2014 were included and examined during a follow-up control. Demographic and clinical data as well as radiographs pre- and postoperatively were evaluated. Additionally, range of motion, DASH Score and Constant-Murley Score (CMS) were analysed in a follow-up examination. Wilcoxon signed-rank test and Spearman's rank correlation were used for statistical analysis. RESULTS: 99 patients (88 m/11 w, 44 y) were included in the present study. 69 (64 m/5 w, 49 y) could be examined during long-term follow-up (38 month). After hook plate removal, the CCD increased significantly (13.7 ± 0.9 mm) compared to the hook plate in situ (9.9 ± 0.8 mm, p = 0.000001). 68% of all patients achieved a full range of motion post-operatively. Main limitations of range of motion affected external rotation as well as ante-/retroversion. Mean DASH Score was 5.6 ± 1 points and CMS 90.0 ± 1.4 points. CONCLUSION: In contrast to a significant higher CCD after hook plate removal, nearly all patients achieved good to excellent functional results for DASH and CMS. This indicates that loss of reduction does not necessarily lead to poor functional outcome after ACJ separation surgery.

[Traumatic thoracic spine fractures: inter- and intraobserver reliability of vertebral, local and segmental kyphosis in lateral X-rays]. / Traumatische Brustwirbelfrakturen: Inter- und Intraobserver-Reliabilität der vertebralen, lokalen undsegmentalen Kyphose im seitlichen Röntgenbild.

BACKGROUND: The evaluation of the vertebral, local and segmental kyphosis according to Cobb is usual practice in the determination of traumatic, idiopathic and degenerative spinal deformities. The present study compares the inter- and intraobserver reliability of these 3 angles in the lateral X-rays of thoracic spine fractures with spinal kyphosis. METHODS: From 1999 till 2007 all patients with adequate X-rays, age < 50 years, traumatic, thoracic spine fracture, kyphotic deformity and surgical intervention were included. The vertebral, local and segmental kyphosis were assessed by 3 observers at 2 time-points in the preoperative lateral X-rays. RESULTS: 63 patients, 11 women and 52 men, with a mean age of 34 years could be evaluated. In all cases an adequate trauma had led to the fracture. The most common trauma was an injury with a motorcycle; the 12th thoracic vertebra was most commonly affected. The segmental kyphosis showed 'excellent' results for inter- and intraobserver reliability (Ø-ICC: 0.8189 and Ø-ICC:0.8003). 'Good' results for inter- and intraobserver reliability could be evaluated for the vertebral (Ø-ICC: 0.7797 and Ø-ICC: 0.7797) and local (Ø-ICC: 0.7532 and Ø-ICC: 0.7296) kyphosis. CONCLUSION: Due to excellent and good results for inter- and intraobserver reliability of the segmental,vertebral and local kyphosis in the lateral X-rays of the thoracic spine, these angles could be a helpful tool, indicating a surgical procedure in traumatic thoracic fractures with kyphosis. Further possible interesting applications in the usage of these 3 angles could be the observation of the vertebral sintering in surgically or conservatively treated vertebral fractures. Appropriate studies should be performed before general recommendations can be given.

Three-dimensional recording of the human face with a 3D laser scanner.

Three-dimensional recording of the surface of the human body or of certain anatomical areas has gained an ever increasing importance in recent years. When recording living surfaces, such as the human face, not only has a varying degree of surface complexity to be accounted for, but also a variety of other factors, such as motion artefacts. It is of importance to establish standards for the recording procedure, which will optimise results and allow for better comparison and validation. In the study presented here, the faces of five male test persons were scanned in different experimental settings using non-contact 3D digitisers, type Minolta Vivid 910). Among others, the influence of the number of scanners used, the angle of recording, the head position of the test person, the impact of the examiner and of examination time on accuracy and precision of the virtual face models generated from the scanner data with specialised software were investigated. Computed data derived from the virtual models were compared to corresponding reference measurements carried out manually between defined landmarks on the test persons' faces. We describe experimental conditions that were of benefit in optimising the quality of scanner recording and the reliability of three-dimensional surface imaging. However, almost 50% of distances between landmarks derived from the virtual models deviated more than 2mm from the reference of manual measurements on the volunteers' faces.