mr lee van rensburg geass munich october 2011. jbjs b vol 49-a, no. 4, june 1967
TRANSCRIPT
Mr Lee Van Rensburg
GEASS Munich
October 2011
JBJS B Vol 49-A, NO. 4, JUNE 1967
Rockwood et al; The Shoulder. 1998: p. 483-553.)
AC ligaments disrupted ACJ dislocated CC ligaments disrupted CC interspace > than normal shoulder
(25-100% more than the normal shoulder)
Deltoid and trapezius muscles usually detached from the distal end of the clavicle
Delto trapezial fascia intact
Type V CC 100% to 300% more than normal
Rockwood et al; The Shoulder. 2004: p. 533
Relative rest Sling comfort ROM
Nothing heavier than cup of tea 6/52 No contact sport 3/12 F/U 6/52
Salvage Modified Weaver Dunn
4 strands 1 PDS
JBJS B Vol 49-A, NO. 4, JUNE 1967
2011
J Shoulder Elbow Surg (2011) 20, S70-S82
20112011
Sling 3 to 4 weeks ROM exercises followed by progressive
strengthening Rehabilitation protocols should be followed
diligently inadequate rehabilitation can be a source of persistent
pain and instability of the ACJ
Return to sports once Full, painless range of motion May require 3 months
J Shoulder Elbow Surg (2011) 20, S70-S82
Favourable outcome in 80% of patients at 1 and 5 years
Functional deficits are minimal, Strength similar to that of the contralateral shoulder 1 report of 17% loss of bench press strength
Persistent ACJ tenderness, instability, shoulder stiffness, and cosmetic deformity may require surgery
J Shoulder Elbow Surg (2011) 20, S70-S82
Chronic acromioclavicular disruption Eleven men Average age of 39 Follow up 55 months 10 patients achieved a good/ excellent result 1 patient had fracture of the base of the coracoid after
heavy lifting in the early postoperative period which resulted in a poor outcome.
2 patients needed an additional operation Excision of the lateral end of the clavicle and removal of screw ASD
Injury. 2007 Nov;38(11):1247-53