Mechanics of coracoacromial ligament transfer augmentation for acromioclavicular joint injuries.

The objective of this study was to determine how effectively the Weaver-Dunn repair (both unaugmented and augmented with a suture and suture anchor) restores joint translation in response to applied loads to normal. Translation of a reference point on the clavicle relative to a reference point on the acromion was assessed in five cadaver shoulders by applying anterior, posterior and superior loads of 50 N to the clavicle using a specially designed test rig while measuring movement of the acromion and clavicle with an optical measurement system. Translation was determined for the intact joint, after simulated injury and Weaver-Dunn repair, and after augmentation of the Weaver-Dunn repair with a suture fixed to a suture anchor in the coracoid process.

Stability of acromioclavicular joint reconstruction: biomechanical testing of various surgical techniques in a cadaveric model.

Background: Despite reports of excellent results with the Weaver-Dunn coracoacromial ligament transfer, many authors recommend augmenting the transfer with supplemental fixation. The authors of this study sought to determine whether there is a biomechanical basis for this assertion and which augmentative method, if any, most closely restored acromioclavicular motion to normal.

Hypothesis: Augmentative coracoclavicular fixation provides better restoration of normal acromioclavicular joint laxity and an increased failure load when compared with the Weaver-Dunn reconstruction alone.

Effect of subacromial decompression on laxity of the acromioclavicular joint: biomechanical testing in a cadaveric model.

Subacromial decompression is a well-accepted treatment for impingement syndrome when nonoperative therapies have failed. However, recent clinical data have raised concern that arthroscopic subacromial decompression may lead to laxity of the acromioclavicular joint and, potentially, predispose patients to late postoperative acromioclavicular joint pain. Our goal was to determine whether subacromial decompression with co-planing of the distal clavicle alters the laxity, or compliance, of the acromioclavicular joint in a cadaveric model.

Nerves in a pinch: imaging of nerve compression syndromes.

Nerve compression is a common entity that can result in considerable disability. Early diagnosis is important to institute prompt treatment and to minimize potential injury. Although the appropriate diagnosis is often determined by clinical examination, the diagnosis may be more difficult when the presentation is atypical, or when anatomic and technical limitations intervene.

Posterior dislocation of the elbow with fractures of the radial head and coronoid.

Background: Posterior dislocation of the elbow with associated fractures of the radial head and the coronoid process of the ulna has been referred to as the "terrible triad of the elbow" because of the difficulties encountered in its management. However, there are few published reports on this injury.

Methods: Eleven patients with this pattern of injury were evaluated after a minimum of two years.