PURPOSE OF THE STUDY Acromioclavicular joint dislocations (AC) represent one of the most frequent injury to the shoulder gridle. Low grade injuries type Rockwood I-II are treated non-operatively. Whereas high grade injuries type Rockwood III-VI are usually treated operatively. At present a wide spectrum of surgical techniques is used: Bosworth screw, hook plate, pinning and tension banding, PDS-sling. In our study the pinning and tension banding technique and the modified orthocord sling technique were compared. The goal of this study was to determine whether there are any clinical and radiological differences between these two techniques. MATERIAL AND METHODS This retrospective non-randomized level 3 evidence study included 58 patients. All of them have sustained a Tossy III AC dislocation. Of the 58 patients, 31 were treated with pinning and tension banding. Modified orthocord (absorbable knitted strand) sling technique (One 2.0-2.5 mm Kirchner wire, orthocord tension banding and coraco-clavicular ligament suture) was used in 27 patients. The same regime was used in postoperative follow up. For the clinical assessment the ASES and Constant score were used. The presence of calcification, degenerative changes, clavicular dislocation were assessed during the X-ray follow-ups. RESULTS The mean treatment time was 18.7 ± 4.9 weeks in the pinning and tension band group (Group A), whereas 15.8 ± 2.8 weeks in the modified orthocord sling technique (Group B). There was a significantly shorter period of healing in Group B. There were no statistically significant differences in the K wire removal time (Group A: 12.6 ± 3.7, Group B: 11.9 ± 3.2). No significant difference was observed between Group A and Group B on the ASES score (Group A: 95 ± 5.8, Group B: 98 ± 3.1) and on the Constant score (Group A: 97.7 ± 3.2, Group B: 97.9 ± 2.9). There were significant differences in both groups between the injured and non-injured shoulder on the Constant score. The mean secondary clavicular dislocation in Group A was 7.2 ± 1.8 mm in the operated shoulder and 4.8 ± 2.0 mm in the non-operated shoulder. The secondary dislocation in Group B was 7.5 ± 2.0 mm in the injured shoulder and 4.2 ± 1.2 mm in the non-injured shoulder. There was a significant difference between the injured and the non-injured shoulder in both groups. Calcification in coraco-clavicular ligament was observed in 15 (48.4%) Group A cases and in 13 (48.1%) Group B cases. Secondary AC joint arthrosis was observed in 8 (25.8%) Group A cases and in 1 (3.7%) Group B case. DISCUSSION No significant difference in clinical outcomes between both the surgical techniques was found. These results are comparable with other, recently published studies. On the other hand, we observed a significantly decreased treatment time with the modified orthocord sling technique. One, centrically inserted Kirschner wire, might better tolerate small rotation movements in the AC joint. Secondary clavicular dislocation, Kirschner wire dislocations and wound complications were similar in both groups and comparable to other, recently published studies. CONCLUSIONS Even though the tension banding and orthocord modified sling rank among the oldest and the cheapest techniques available for AC dislocation treatment, their results are comparable with modern and costly techniques. The orthocord modified sling technique has an advantage of fast and cheap material extraction in outpatient conditions. Key words: AC dislocation, acromioclavicular joint dislocation, orthocord sling, tension banding, AC disruption, acromioclavicular joint disruption.
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Materials (Basel)
September 2024
China Ordnance Industrial Standardization Research Institute, Beijing 100089, China.
Ti-based bulk metallic glass composites (BMGMCs) containing an formed metastable β phase normally exhibit enhanced plasticity attributed to induced phase transformation or twinning. However, the underlying deformation micromechanism remains controversial. This study investigates a novel deformation mechanism of Ti-based BMGMCs with a composition of TiZrCuNbNiBe (at%).
View Article and Find Full Text PDFInjury
June 2024
Department of Orthopaedics & Rehabilitation, Penn State College of Medicine, 500 University Dr. Hershey, PA 17033 USA.
Introduction: Multiplanar mesh plating of patella fractures has become more popular in recent years. It was the goal of this study to compare the biomechanical stability of cannulated screw with anterior tension band to multiplanar mesh plating for fixation of transverse patella fractures in cadaver specimens.
Materials And Methods: Eight matched pairs of fresh frozen cadaveric knees were obtained and soft tissues dissected leaving the extensor mechanism, joint capsule, and retinaculum intact.
Ecol Evol
September 2023
Institute of Biology Leiden, Leiden University Leiden The Netherlands.
When two putatively cryptic species meet in nature, hybrid zone analysis can be used to estimate the extent of gene flow between them. Two recently recognized cryptic species of banded newt (genus ) are suspected to meet in parapatry in Anatolia, but a formal hybrid zone analysis has never been conducted. We sample populations throughout the range, with a focus on the supposed contact zone, and genotype them for 31 nuclear DNA SNP markers and mtDNA.
View Article and Find Full Text PDFBackground: Addressing neck contouring with surgical and nonsurgical aesthetic procedures includes understanding the origin of platysmal banding. A theory was postulated to explain this phenomenon by isometric vs isotonic muscular contraction patterns. However, no scientific proof had been provided to date for its correctness.
View Article and Find Full Text PDFOper Orthop Traumatol
October 2023
Orthopädische Klinik König-Ludwig-Haus, Lehrstuhl für Orthopädie, Universität Würzburg, Brettreichstr. 11, 97074, Würzburg, Deutschland.
Objective: Patient-specific osteosynthesis for pseudarthrosis of the acromion.
Indications: Symptomatic pseudarthrosis of the acromion at the level of a meta/mesacromion.
Contraindications: Infection; patient noncompliance regarding postoperative treatment protocol.
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