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Arthroscopy 2022 05;38(5):1396-1397

The Steadman Clinic and Steadman Philippon Research Institute, Vail, Colorado.

Treatment of recurrent anterior shoulder instability has gained significant interest in recent years and involves evaluation of both glenoid and humeral sided bone loss. Decision making is more complex in patients with significant humeral or glenoid bone defects or in those who underwent previous instability surgery. Appropriate assessment of the glenoid track is necessary as "off track" lesions typically require treatments beyond arthroscopic labral repair alone. Read More

J Clin Med 2022 Feb 16;11(4). Epub 2022 Feb 16.

Department of Orthopaedic Surgery, Kangdong Sacred Heart Hospital, Seoul 05355, Korea.

We investigated the complications and frequency of hook plate fixation in patients with shoulder trauma. We reviewed 216 cases of hook plate fixation use at our hospital between January 2010 and May 2020. Finally, we included 76 cases of acute distal clavicle fracture (DCF) and 84 cases of acute acromioclavicular joint dislocation (ACD). Read More

Medicine (Baltimore) 2021 Nov;100(47):e27894

Department of Orthopedics, The Third Hospital of Mianyang Sichuan Mental Health Center, No. 190 The East Jiannan Road, Mianyang, China.

Rationale: Acromioclavicular joint (ACJ) dislocation combined with ipsilateral midclavicular fracture is extremely unusual and is a high-energy injury to the shoulder. A review of the literature divides the treatment of clavicular fractures is divided into nonsurgical treatment, plates, and intramedullary nailing, while the options for ACJ dislocation are elastic fixation and rigid fixation. However, there is still a lack of consensus about the most appropriate way to treat this shoulder injury. Read More

Unfallchirurg 2022 Feb 18;125(2):97-106. Epub 2021 Dec 18.

Orthopädie Ackermann, Raiffeisenstr. 58-60, 47259, Duisburg, Deutschland.

In this article the basic principles of fracture sonography and meaningful areas of application in children and adults are explained. The sonographic fracture signs are presented and the typical areas of application, i.e. Read More

BMC Musculoskelet Disord 2021 Nov 22;22(1):969. Epub 2021 Nov 22.

Department of Orthopedics, Shanghai First People's Hospital, Shanghai Jiao Tong University, 200080, Shanghai, China.

Background: Os acromiale can be potentially missed or misdiagnosed as acromion fracture, and this can affect treatment determination if it is complicated with an ipsilateral shoulder injury. The clavicle hook plate is a widely used technique for distal clavicle injuries, leading to transacromial erosion, particularly when in the presence of os acromiale.

Case Presentation: A 70-year-old man and a 78-year-old man who had limited mobility and severe pain in their right shoulders following falls attended the emergency center. Read More

Injury 2022 Apr 27;53(4):1562-1567. Epub 2021 Oct 27.

Department of Thoracic Surgery, Hospital "KAT", Athens, Greece.

Introduction: Anterior sternoclavicular joint dislocation (SCJ) is a relative rare injury, related to high energy trauma. The objective of the present study is to present a novel suture technique for treatment of anterior SCJ traumatic dislocation and to report clinical outcomes from a small case series undergoing this procedure.

Patients And Methods: Patients presenting with traumatic anterior SCJ disruption in our institution were eligible to participate. Read More

J Orthop Trauma 2021 08;35(Suppl 2):S9-S10

Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, New York, NY.

Summary: Operative management of sternoclavicular fracture-dislocations is recommended in the setting of symptomatic nonunion. Treatment options include open reduction internal fixation, fragment excision, and ligamentous reconstruction. We present a 29-year-old man with a medial clavicle fracture nonunion that previously failed open reduction internal fixation and was treated with sternoclavicular joint reconstruction using tendon allograft. Read More

JBJS Case Connect 2021 06 23;11(2). Epub 2021 Jun 23.

Department of Orthopaedic Surgery, Begoña Hospital, Gijón, Spain.

Case: A 41-year-old man sustained a midshaft clavicle fracture with associated type IV ipsilateral acromioclavicular joint (ACJ) dislocation. The clavicle was fixed with a locking plate and ACJ stabilized with a novel technique: 2 metal anchors with preloaded suture fixed at the coracoid process, looping the sutures over the clavicle, and passing through the plate holes without clavicle bone drilling. Excellent functional outcomes for range of motion, pain, and functional scores persisted 2 and a half years after surgery. Read More

Jt Dis Relat Surg 2021 11;32(2):560-565. Epub 2021 Jun 11.

Department of Orthopaedics and Traumatology, Landesklinikum Baden-Mödling, 2340 Mödling, Austria.

A combination of an anterior sternoclavicular (SC) joint dislocation with a midshaft clavicle fracture is an extremely rare injury. If left untreated, it can lead to severely impaired function of the shoulder with a high risk for complications. A 45-year-old male patient presented with pain and impaired range of motion (ROM) in the left shoulder after a mountain bike crash. Read More

BMC Musculoskelet Disord 2021 Jun 9;22(1):528. Epub 2021 Jun 9.

Division of Arthroscopy, Joint Surgery and Sport Injuries, Department of Orthopedics, Trauma, and Plastic Surgery, University of Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany.

Background: The purpose of this study was to present a navigated image-free augmentation technique for the acromioclavicular joint (ACJ) and coracoclavicular (CC) ligaments and to report the clinical and radiological outcomes.

Methods: From 2013 to 2018, 35 eligible patients were treated with our navigated image-free ACJ- and CC-augmentation technique. The average follow-up was 3 years. Read More

Orthop Traumatol Surg Res 2021 09 24;107(5):102965. Epub 2021 May 24.

Service de Chirurgie de l'Arthrose et du Sport, Urgences Traumatiques des Membres. CHU de Grenoble-Alpes, Hôpital Sud, avenue de Kimberley, BP 338, 38434 Échirolles cedex, France.

Introduction: Shoulder trauma with normal radiographs is a frequent emergency presentation. The predominance of pain makes clinical examination unreliable, and complementary imaging is often needed for diagnosis. The aim of the present study was to assess the contribution of ultrasonography (US) and magnetic resonance imaging (MRI) in deciphering such trauma. Read More

Trauma Case Rep 2021 Jun 21;33:100483. Epub 2021 Apr 21.

Starship Hospital Orthopaedic Department, 2 Park Road, Grafton, Auckland 1023, New Zealand.

The primary stabiliser of the diarthrodial sterno-clavicular (SC) joint is the costo-clavicular ligament, this holds the clavicle to the first costal cartilage and the end of the first rib. The costo-clavicular and surrounding ligaments help maintain the stability and strength of the SC joint. As a result, SC joint dislocations are far less common than fractures to the clavicle due to the relatively larger forces required to disrupt these ligaments. Read More

Clin J Sport Med 2022 05 22;32(3):e319-e321. Epub 2020 Sep 22.

Departments of Orthopaedic Surgery.

Abstract: Traumatic and sport-related sternoclavicular (SCJ) injuries in adolescent athletes are more commonly physeal fractures rather than true SCJ dislocations. Although rare, posterior displacement of the medial clavicular metaphysis after a physeal fracture necessitates prompt evaluation and treatment. Despite the inherent healing ability of physeal separations, delayed or failed diagnosis has the capacity to cause serious complications or fatality secondary to injury of retrosternal structures. Read More

Curr Sports Med Rep 2021 May;20(5):242-245

Division of Pediatric Orthopaedics, Department of Orthopaedics and Rehabilitation, University of Florida College of Medicine, Gainesville, FL.

Zhongguo Gu Shang 2021 03;34(3):234-6

Department of Emergency, the First People's Hospital of Shangqiu, Shangqiu Clinical College of Xuzhou Medical University, Shangqiu 476000, Henan, China.

Acta Biomed 2020 12 30;91(14-S):e2020015. Epub 2020 Dec 30.

a) Department of Medicine and Surgery, Orthopaedic Clinic, Parma University Hospital, Via Gramsci 14,43100 Parma, Italy.

Sternoclavicular joint dislocation (SCJD) is a rare injury, generally classified in anterior and posterior. The posterior SCJD is very infrequent yet potentially associated with life-threatening complications. In patients with unfused medial clavicle physis, SCJD can be associated with fracture-dislocation (Salter type I or II). Read More

Am J Case Rep 2020 Oct 12;21:e924889. Epub 2020 Oct 12.

Department of Orthopaedics, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China (mainland).

BACKGROUND Bipolar dislocation of the clavicle is a rare disease that is often associated with some high-energy injuries. It refers to concomitant dislocation of the ipsilateral acromioclavicular joint and sternoclavicular joint. Because of its rarity, the diagnosis of bipolar dislocation of the clavicle is often difficult. Read More

Medicine (Baltimore) 2020 Sep;99(39):e22324

Orthopaedic Medical Center, the Second Hospital of Jilin University, Changchun, China.

Rationale: Coracoid processes (CPs) fracture with acromioclavicular (AC) joint dislocation are extremely rare. This combined injury has brought many challenges to surgeons, and the mechanism underlying the injury is still not fully understood. There is no clear consensus on its treatment. Read More

Knee Surg Sports Traumatol Arthrosc 2021 Jul 20;29(7):2103-2109. Epub 2020 Jul 20.

Department of Shoulder and Elbow Surgery, Patras University Hospital, Papanikolaou 1, 26504, Patras, Greece.

Purpose: The optimal (SBJI) surgical treatment for acute acromioclavicular (AC) joint disruption remains controversial. What is being presented is the long-term functional outcomes of a double cross-looped coracoclavicular (CC) suture technique with the intention of restoring both anteroposterior and superior displacement of the clavicle.

Methods: Between 2007 and 2016, 81 patients underwent surgical reconstruction for acute acromioclavicular joint (AC) disruption in two orthopaedic centers. Read More

J Shoulder Elbow Surg 2020 Jul;29(7S):S92-S100

Steadman Hawkins Clinic of the Carolinas, Prisma Health-Upstate, Greenville, SC, USA.

Background: The management of high-grade acromioclavicular separations remains unclear. The surgical interventions have shifted to more anatomic, less invasive techniques. The purpose of this study was to systematically review the outcomes and complications of anatomic coracoclavicular ligament reconstruction using a tendon graft. Read More

Int Orthop 2021 04 20;45(4):1009-1015. Epub 2020 May 20.

Institute of Anatomy, First Faculty of Medicine, Charles University Prague, Prague, Czech Republic.

Purpose: Until now, classifications of coracoid fractures have been based on plain radiographs, without use of 3D CT reconstructions. Therefore, the aim of the present study has been to describe the pathoanatomy of these fractures and their associated injuries to the shoulder girdle, on the basis of 3D CT reconstructions.

Methods: The cohort comprised 39 patients, who each sustained a coracoid fracture investigated with 3D CT reconstructions. Read More

Radiologe 2020 Jun;60(6):541-548

Unfallchirurgische Klinik, Medizinische Hochschule Hannover, Hannover, Deutschland.

Background: The shoulder girdle is a chain of bones and joints which connect the upper extremity to the axial skeleton. The shoulder as a biomechanical unit has a remarkable range of motion and is therefore frequently prone to injuries of the three major joints (sternoclavicular joint, acromioclavicular joint, glenohumeral joint) and the bony elements (clavicle, scapula, humerus). Projection radiography is still the first imaging modality for injuries of the shoulder and usually sufficient for initial diagnosis and injury classification. Read More

Injury 2020 Dec 9;51 Suppl 4:S54-S58. Epub 2020 Mar 9.

Department of Orthopaedics and Traumatology, Cliniques Universitaires de Bruxelles, Hôpital Erasme, Université libre de Bruxelles, Route de Lennik 808, 1070 Bruxelles, Brussels, Belgium.

Diaphyseal fractures of the clavicle had until recently the reputation to always heal with abundant callus formation, except if operated, due to a reported high rate of nonunion after plate fixation by older series. The reason would be that the bone has only periosteal vascularization, easily destroyed by periosteal stripping for implant apposition. Bone autograft and external fixation has been reported as the best technique to heal a nonunited clavicle nonunion. Read More

Medicine (Baltimore) 2019 Dec;98(51):e18433

Department of Orthopedics and Traumatology, San Raffaele Scientific Institute.

Rationale: Posterior sternoclavicular joint dislocations (PSCJDs) are particularly rare injuries, accounting for 3% to 5% of sternoclavicular joint dislocations. With very few cases reported in the literature, these injuries are often misdiagnosed and imaging is not always clear, thus making physicians often unaware of them. The present case report aims to investigate a rare case involving a clavicular Salter-Harris II fracture with associated posterior displacement of the diaphysis, a term coined a "pseudodislocation. Read More

Emerg Med Clin North Am 2020 Feb;38(1):103-124

Department of Emergency Medicine, Feinberg School of Medicine, Northwestern University, 211 East Ontario Street, Suite 200, Chicago, IL 60611, USA; United States Soccer Federation.

Shoulder pain is a common presentation in the emergency department. The list of differential diagnoses is broad. This article summarizes common diagnoses of shoulder pain, including bony, infectious, and connective tissue pathologies and their proper treatment. Read More

J Orthop Trauma 2019 Nov;33(11):e439-e446

Department of Orthopaedic Surgery, The Warren Alpert Medical School of Brown University, Providence, RI.

Objectives: The purpose of this study was to systematically review and quantitatively analyze outcomes in operative versus nonoperative management of displaced midshaft clavicle fractures in pediatric and adolescent patients.

Data Sources: Using the Preferred Reporting items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, systematic searches of PubMed and EMBASE were conducted to identify English-language studies reporting outcomes in displaced pediatric midshaft clavicle fractures from 1997 to 2018.

Study Selection: Studies that reported on outcomes of operative and/or nonoperative treatment of displaced midshaft clavicle fractures in patients younger than 19 years were included. Read More

J Orthop Trauma 2020 Jan;34(1):e20-e25

Division of Orthopaedic Trauma, Department of Orthopaedics, The Ohio State University, Columbus, OH.

Objectives: To describe surgical technique for proper placement of the clavicle hook plate, determine whether there is subacromial impingement caused by hook plate fixation, and evaluate the mechanical strength of the clavicle hook plate construct.

Methods: Eight fresh-frozen cadaveric shoulders with a mean age of 48 years (range, 37-69) were used. Open reduction and internal fixation of simulated Rockwood type V AC joint dislocation was performed with the clavicle hook plate. Read More

J Bone Joint Surg Am 2019 Aug;101(15):1335-1341

The Shoulder Injury Clinic, Edinburgh Orthopaedic Trauma Unit, Edinburgh, United Kingdom.

Background: Fractures of the lateral aspect of the clavicle with complete displacement have a high nonunion rate and are associated with poor functional outcomes following nonoperative treatment. Various techniques are available to treat these fractures, but preliminary studies of open reduction and tunneled suspensory device (ORTSD) fixation have shown good early functional outcomes with a low rate of complications; our goal was to assess the functional outcomes and complications in the medium term in a larger series of patients treated using this technique.

Methods: Sixty-seven patients with displaced lateral-end clavicular fractures were treated with ORTSD fixation. Read More

Medicine (Baltimore) 2019 Jul;98(28):e16359

Department of Orthopedics.

Rationale: Asymmetrical bilateral sternoclavicular joint (SCJ) dislocation consists of posterior SCJ dislocation on one side and anterior SCJ dislocation on the other side. This is an extremely rare injury and only a few cases have been reported in the literature. If not been diagnosed timely and accurately, asymmetrical bilateral SCJ dislocation can be life-threatening. Read More

Orthop J Sports Med 2019 May 31;7(5):2325967119847470. Epub 2019 May 31.

Institute of Sports Imaging, National Institute of Sport, Expertise, and Performance, Paris, France.

Background: Judo is a full-contact fighting sport that may lead to severe injuries. There are limited data available on the incidence of judo-related injuries. The French Judo Federation has established a surveillance system to document the frequency and type of injuries during judo competitions. Read More