Rosa López-Vidriero Tejedor , Emiliano Gallardo Ordoñez , Luis Fernández Rosa , Rafael Arriaza , Emilio López-Vidriero Tejedor
{"title":"Papel de la disfunción escapulotorácica en la afección de la articulación acromioclavicular","authors":"Rosa López-Vidriero Tejedor , Emiliano Gallardo Ordoñez , Luis Fernández Rosa , Rafael Arriaza , Emilio López-Vidriero Tejedor","doi":"10.1016/j.reaca.2015.06.010","DOIUrl":"10.1016/j.reaca.2015.06.010","url":null,"abstract":"<div><p>The scapulothoracic and acromioclavicular (AC) joints are inter-related to form the shoulder suspensory complex. Therefore, patients with any kind of AC dislocation may present with biomechanical scapular alterations and suffer scapular dyskinesis.</p><p>In the present article, the concept of dyskinesis is reviewed, as well as the evaluation criteria and the different types of classifications.</p><p>The relationship between acromioclavicular joint dislocation and dyskinesis is also assessed. The anatomic aspects, the increased presence of dyskinesis within the different kind of AC injuries and their causative hypothesis are also reviewed. Finally, the results of the rehabilitation program and the surgical treatment for type III AC dislocations are reviewed in relation to dyskinesis.</p></div>","PeriodicalId":101107,"journal":{"name":"Revista Espa?ola de Artroscopia y Cirugía Articular","volume":"22 1","pages":"Pages 66-71"},"PeriodicalIF":0.0,"publicationDate":"2015-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.reaca.2015.06.010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123391581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
José Luis Ávila Lafuente, Santos Moros Marco, Oscar Jacobo Edo, Cristina García-Polín López, Carmen García Rodríguez, Teresa del Olmo Hernández
{"title":"Fracturas de clavícula distal","authors":"José Luis Ávila Lafuente, Santos Moros Marco, Oscar Jacobo Edo, Cristina García-Polín López, Carmen García Rodríguez, Teresa del Olmo Hernández","doi":"10.1016/j.reaca.2015.06.012","DOIUrl":"10.1016/j.reaca.2015.06.012","url":null,"abstract":"<div><p>Fractures of the clavicle account for 4% of adult fractures. About 18% of them are located in the lateral end of the clavicle. The location, relationship with coraco-clavicular ligaments and pattern of injury are of considerable importance in stability of the fracture. For the most part, they have been treated conservatively. Surgical treatment is necessary in displaced fractures. It is usually managed with plating and Kirschner wires with tension-band wires. Specific plates were engineered, such as the hook-plate, improving the results. Arthroscopic assisted treatment is rare and based on acromioclavicular dislocation procedures.</p></div>","PeriodicalId":101107,"journal":{"name":"Revista Espa?ola de Artroscopia y Cirugía Articular","volume":"22 1","pages":"Pages 49-53"},"PeriodicalIF":0.0,"publicationDate":"2015-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.reaca.2015.06.012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125090824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maria Valencia Mora, Jorge Diaz Heredia, Raquel Ruiz Diaz, Miguel Ángel Ruiz-Ibán
{"title":"Exploración y evaluación radiológica de la articulación acromioclavicular","authors":"Maria Valencia Mora, Jorge Diaz Heredia, Raquel Ruiz Diaz, Miguel Ángel Ruiz-Ibán","doi":"10.1016/j.reaca.2015.06.003","DOIUrl":"10.1016/j.reaca.2015.06.003","url":null,"abstract":"<div><p>The subcutaneous location of the acromioclavicular joint allows the clinician to evaluate deformities directly and palpate the joint. This is more complicated in the glenohumeral joint. However, pain arising from the joint can irradiate to different areas of the shoulder, arm and neck, and can be misleading. Thus, it is important to be familiar with the spectrum of physical examination tests, specific radiological projections and MRI findings in order to reach an accurate diagnosis.</p><p>The aim of this article is to systematically describe the most commonly used physical examination tests for acromioclavicular pathology, including sensitivity, specificity, and predictive values for all of them. Secondly, to analyse the radiological particularities of this joint and to establish the usefulness of the specific projections and imaging techniques.</p></div>","PeriodicalId":101107,"journal":{"name":"Revista Espa?ola de Artroscopia y Cirugía Articular","volume":"22 1","pages":"Pages 11-17"},"PeriodicalIF":0.0,"publicationDate":"2015-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.reaca.2015.06.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127138903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jorge Díaz Heredia, Raquel Ruiz Díaz, María Valencia Mora, Miguel Angel Ruiz Ibán
{"title":"¿Por qué tratamiento conservador de las luxaciones acromioclaviculares tipo iii?","authors":"Jorge Díaz Heredia, Raquel Ruiz Díaz, María Valencia Mora, Miguel Angel Ruiz Ibán","doi":"10.1016/j.reaca.2015.06.001","DOIUrl":"10.1016/j.reaca.2015.06.001","url":null,"abstract":"<div><p>Despite being a common injury, the treatment of grade <span>iii</span> acromioclavicular joint dislocation remains subject to debate, because there is a lack of consensus regarding its optimal management. The purpose of this article is to defend, based on the existing scientific evidence, the conservative treatment as the most adequate option due to the good results obtained and the low complication rate.</p></div>","PeriodicalId":101107,"journal":{"name":"Revista Espa?ola de Artroscopia y Cirugía Articular","volume":"22 1","pages":"Pages 28-32"},"PeriodicalIF":0.0,"publicationDate":"2015-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.reaca.2015.06.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130686149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Miguel García Navlet , Cristina Victoria Asenjo Gismero
{"title":"Razones para la cirugía precoz en las luxaciones acromioclaviculares tipo iii","authors":"Miguel García Navlet , Cristina Victoria Asenjo Gismero","doi":"10.1016/j.reaca.2015.06.002","DOIUrl":"10.1016/j.reaca.2015.06.002","url":null,"abstract":"<div><p>There is growing interest to learn more about the complex scapulo-humeral biomechanics in order to apply them for a full and satisfactory recovery of our patients at discharge as well as for their future.</p><p>Applying the most appropriate treatment for acromioclavicular dislocations should be based on a clear standardisation when categorising the lesions, and associating a treatment option to each category. To considering this as solved question to date, seems arbitrary, since neither the imaging or clinical classification methods are well defined, and the surgical interventions are adequately compared to the non-surgical option in the literature.</p><p>There even appears to be a lack of data in the evaluation of outcomes. If it is considered that scapular dyskinesis puts our patients at risk of suffering a bad recovery after these dislocations, and that our main objective is getting the shoulder back to normal, it should be associated with trying to avoid this condition as far as possible. Thus, it should depend not only on good coordination and muscle training, but also on obtaining strong and stable articular structures that will support the heavy loads that the shoulder will have to bear.</p><p>In this review, it is suggested that early indication for surgery of acromioclavicular joint dislocations type<!--> <span>iii</span>, from an evidence based point of view, is not possible due to the numerous recommendations against surgery that have been published, and will probably be discussed in another chapter of this journal.</p><p>Therefore, this has been structured on a point of view based on reasonable doubts due to the arrival of new surgical techniques, new biomechanics studies on these techniques, and the growing interest in scapular dyskinesis and its importance in shoulder dysfunction.</p></div>","PeriodicalId":101107,"journal":{"name":"Revista Espa?ola de Artroscopia y Cirugía Articular","volume":"22 1","pages":"Pages 24-27"},"PeriodicalIF":0.0,"publicationDate":"2015-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.reaca.2015.06.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129214269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Francisco de Borja Serrano Sáenz de Tejada , María Santos Oliete
{"title":"Rehabilitación de la cirugía de la articulación acromioclavicular","authors":"Francisco de Borja Serrano Sáenz de Tejada , María Santos Oliete","doi":"10.1016/j.reaca.2015.06.004","DOIUrl":"10.1016/j.reaca.2015.06.004","url":null,"abstract":"<div><p>There is not enough evidence to recommend a particular surgical technique for the surgical treatment of acromioclavicular joint dislocations. There is a lack of studies in the literature evaluating rehabilitation programs to treat post-operative acromioclavicular dislocations, although enough data can be found to make some recommendations.</p><p>Length of immobilisation depends on tissue healing time frames of the surgical procedure. In general, the joint must be protected for the first 3 to 6 weeks to allow the biological healing process. Active range of motion is initiated at 6 to 8 weeks, with resistance strength activities withheld for 12 weeks.</p><p>When the brace is removed, the patient can start with passive assisted range of motion exercises. Caution must be used with internal rotation behind the back, cross-body adduction, and end range forward elevation. After 6 weeks, active exercises can be added with support of the limb on a table or wall.</p><p>Scapular dyskinesia has been related to acromioclavicular dislocation. For this purpose, closed chain scapular exercises with the hand fixed to a wall or table are recommended in early stages (6 to 8 weeks after surgery). Isotonic strength exercise can be started after 12 weeks, with tubing or cable resistance. Open chain exercises, like Blackburn's, produce stress in the acromioclavicular joint and should be left for an advanced phase of treatment.</p></div>","PeriodicalId":101107,"journal":{"name":"Revista Espa?ola de Artroscopia y Cirugía Articular","volume":"22 1","pages":"Pages 72-80"},"PeriodicalIF":0.0,"publicationDate":"2015-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.reaca.2015.06.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116300110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Anatomía y función de la articulación acromioclavicular","authors":"Adrián Cuéllar Ayestarán , Ricardo Cuéllar Gutierrez","doi":"10.1016/j.reaca.2015.06.005","DOIUrl":"10.1016/j.reaca.2015.06.005","url":null,"abstract":"<div><p>In order to treat acromioclavicular disorders, one should know the anatomy of the joint and the nearby structures that influence it. This knowledge is necessary to know how to diagnose what may be the cause of the disorder, to assess which are the structures that must be rebuilt after a joint injury, and to know which structures should be respected during the surgery. In this article, the bony anatomy, the anatomy and function of the ligaments that act on this joint, biomechanics, and the pathophysiology of the acromioclavicular joint is presented.</p></div>","PeriodicalId":101107,"journal":{"name":"Revista Espa?ola de Artroscopia y Cirugía Articular","volume":"22 1","pages":"Pages 3-10"},"PeriodicalIF":0.0,"publicationDate":"2015-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.reaca.2015.06.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121347515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Patología degenerativa de la articulación acromioclavicular","authors":"Alberto Marqués Rapela","doi":"10.1016/j.reaca.2015.06.015","DOIUrl":"10.1016/j.reaca.2015.06.015","url":null,"abstract":"<div><p>Acromioclavicular osteoarthritis is a common cause of pain in the anterior part of the shoulder joint, particularly when crossing the arms above the head.</p><p>It usually appears in middle-aged men and women, and the suspected diagnosis is based on clinical history and physical examination. The complementary tests and proper and complete therapeutic response to an injection with corticosteroid /anaesthetic solutions confirms their diagnosis.</p><p>The instability of this joint is one of the conditions to consider in the differential diagnosis as it presents with a similar clinical picture and similar findings in the physical examination.</p><p>There are several treatment options, although initial treatment should be conservative. If there is no clinical response, surgical treatment will be indicated by open or arthroscopic resection of the joint. Meticulous surgical technique in both cases will minimise potential complications and improve the degree of clinical and functional recovery of the patient.</p></div>","PeriodicalId":101107,"journal":{"name":"Revista Espa?ola de Artroscopia y Cirugía Articular","volume":"22 1","pages":"Pages 59-65"},"PeriodicalIF":0.0,"publicationDate":"2015-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.reaca.2015.06.015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128403348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Santos Moros Marco, José Luis Ávila Lafuente, Óscar Jacobo Edo, Teresa Del Olmo Hernández, Carmen García Rodriguez, Cristina García-Polín López
{"title":"Inestabilidad acromioclavicular aguda: epidemiología, historia natural e indicaciones de cirugía","authors":"Santos Moros Marco, José Luis Ávila Lafuente, Óscar Jacobo Edo, Teresa Del Olmo Hernández, Carmen García Rodriguez, Cristina García-Polín López","doi":"10.1016/j.reaca.2015.06.011","DOIUrl":"10.1016/j.reaca.2015.06.011","url":null,"abstract":"<div><p>Acromioclavicular dislocations are common injuries of the scapular girdle, especially among young men during sport activities. There is general consensus for non-surgical treatment of Rockwood type <span>i</span> and <span>ii</span> injuries and for surgical treatment of Rockwood type <span>iv</span>, <span>v</span>, <span>vi</span> injuries. Treatment of Rockwood type <span>iii</span> injuries remains controversial because of the lack of evidence that supports best treatment option due to mixed results reported in the literature, although young patients with high physical demand may have a slight advantage with a surgical approach. The main aim of this review article is to present the epidemiology, mechanisms of injury, classification, natural history, and indications for surgery of acromioclavicular dislocations, in order to achieve a better knowledge about them and to be able to get an optimal result after treatment.</p></div>","PeriodicalId":101107,"journal":{"name":"Revista Espa?ola de Artroscopia y Cirugía Articular","volume":"22 1","pages":"Pages 18-23"},"PeriodicalIF":0.0,"publicationDate":"2015-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.reaca.2015.06.011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116645555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}