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