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Axial and tangential views of the acromioclavicular joint： the introduction of new projections

Chinese Medical Journal 2012年第14期125卷 2493-2498页

作者： CHEN Wei ZHAGN Qi SU Yan-ling ZHANG Ze-kun HOU Zhi-yong PAN Jin-she ZHANG Xiao-lin ZHANG Ying-ze Department of Orthopaedic Surgery Third Hospital of HebeiMedical University Shijiazhuang Hebei 050051 China Department of Epidemlology and Statistics Hebei MedicalUniversity Shijiazhuang Hebei 050051 China

Background Routine anteroposterior radiographs of the acromioclavicular （AC） joint with or without weight bearing have limitations in demonstrating the AC joint. Transarticular fixation with Kirschner wire is a treatment choice for AC dislocations. However, percutaneous fixation of the AC joint is technically demanding. The C-arm fluoroscopy can be used as routine intraoperative guidance to facilitate this procedure. The current study aims to introduce new projections, the axial and tangential views of AC joint, to help evaluate the severity of the injury and facilitate the percutaneous procedure. Methods Three shoulder specimens were used to find the projection directions of the axial and tangential views of the AC joint by using the digital radiography （DR） unit. The axial and tangential views were taken of 20 adult volunteers by referencing the projection directions determined in the shoulder specimens. The angles showed on the DR system and the angles between the coronal plane of the body and the vertical plane of the flat panel detector （FPD） during taking these radiographs were recorded. The C-arm fluoroscopy unit was used to take the axial and tangential views referencing the angles measured on the DR system. Routine anteroposterior radiographs of the AC joint were taken on the volunteers. The minimal distances from the distal clavicle to the acromion were measured on both tangential and anteroposterior radiographs. The data was statistically analyzed. Results The clear axial and tangential radiographs of AC joints of the volunteers were obtained using both DR and C-arm fluoroscopy units. The angles demonstrated on the DR window are （20.8±2.4）° for male and （18.3±2.3）° for female. During taking the axial views, the angles between the coronal plane of the body and vertical plane of FPD are （23.3±3.2）° for male and （20,1±2.4）° for female. During taking tangential views, the corresponding angles are （117.5±3.7）° for male and （113.1±3.3）° for female. On the tange

关键词： acromioclavicularjoint axial view, tangential view, dislocation, percutaneous fixation

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Reconstruction of chronic acromioclavicular joint disruption with artificial ligament prosthesis

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Chinese Journal of Traumatology 2013年第4期16卷 216-220页

作者： Devendra Kumar Chouhan Uttam Chand Saini Mandeep Singh Dhillon Department of Orthopaedics Post Graduate Instituteof Medical Education & Research Sector 12 Chandigarh160012 India

Objective： Management of Rockwood type 3 acromioclavicular disruptions is a matter of debate. Should we adopt conservative or operative measures at first presentation？ It is not clear but most of the evidences are in favour of conservative management. We present our expe- rience in managing these patients surgically. Methods： We present a prospective series of eight cases of chronic Rockwood type 3 acromioclavicular joint disruptions treated surgically. Anatomical reconstruction of the coracoclavicular ligament was done by artificial braided polyester ligament prosthesis： Results： All the patients were able to perform daily activities from an average of the 14th postoperative day. All patients felt an improvement in pain, with decrease in ave- rage visual analogue scale from preoperative 6.5 points （range 3-9 points） to 2.0 points （range 0-5 points）, Constant score from 59% to 91% and American Shoulder and Elbow Surgeons shoulder score from 65 to 93 points postoperatively. These results improved or at least remained stationary on midterm follow-up, and no deterioration was recorded at an average follow-up of 46 months. Conclusion： This midterm outcome analysis of the artificial ligament prosthesis is the first such follow-up study with prosthesis. Our results are encouraging and justify the further use and evaluation of this relatively new and easily reproducible technique.

关键词： acromioclavicularjoint Prostheses and implants Reconstructive surgical procedures Ligaments

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