Natascha Kraus, Carmen Hann, Christian Gerhardt, Markus Scheibel
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All patients underwent posttraumatic clinical-Taft Score (TF), Acromioclavicular Joint Instability Score (ACJI), Constant Score (CS), Subjective Shoulder Value (SSV)-and radiological (bilateral anteroposterior stress and bilateral Alexander views) evaluation.</p><p><strong>Results: </strong>According to the RW classification, the following AC dislocations were present: eight (13.1%) type I, nine (14.8%) type II, 22 (36.1%) type III, and 22 (36.1%) type V. Based on the clinical and radiographic results, a new classification is proposed: Type I instabilities show only a partial vertical displacement (≤30% coracoclavicular distance [CCD]) and type II a complete vertical displacement (>30% CCD). Both type I and II are further graded into none or partial (A) and complete DHT (B) as seen on bilateral Alexander views.</p><p><strong>Conclusion: </strong>DHT can be found in low-grade instabilities and lead to inferior clinical results in the posttraumatic situation.</p>","PeriodicalId":43682,"journal":{"name":"Obere Extremitaet-Schulter-Ellenbogen-Hand-Upper Extremity-Shoulder Elbow Hand","volume":"13 4","pages":"279-285"},"PeriodicalIF":0.5000,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s11678-018-0469-x","citationCount":"25","resultStr":"{\"title\":\"Dynamic instability of the acromioclavicular joint: A new classification for acute AC joint separation.\",\"authors\":\"Natascha Kraus, Carmen Hann, Christian Gerhardt, Markus Scheibel\",\"doi\":\"10.1007/s11678-018-0469-x\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Acute acromioclavicular (AC) dislocation is classified according to Rockwood (RW). Although of clinical relevance, dynamic horizontal translation (DHT) is not listed in this classification or in frequently used clinical evaluation tools. The aim of this study was (a) to evaluate vertical and horizontal AC joint instabilities and assess their combined occurrence and clinical appearance in a consecutive group of patients, as well as (b) to develop a new classification of acute AC joint dislocation.</p><p><strong>Method: </strong>A consecutive group of 61 patients (seven female, 54 male) with a mean age of 34.5 years (18.9-60.1) were included in the study. All patients underwent posttraumatic clinical-Taft Score (TF), Acromioclavicular Joint Instability Score (ACJI), Constant Score (CS), Subjective Shoulder Value (SSV)-and radiological (bilateral anteroposterior stress and bilateral Alexander views) evaluation.</p><p><strong>Results: </strong>According to the RW classification, the following AC dislocations were present: eight (13.1%) type I, nine (14.8%) type II, 22 (36.1%) type III, and 22 (36.1%) type V. Based on the clinical and radiographic results, a new classification is proposed: Type I instabilities show only a partial vertical displacement (≤30% coracoclavicular distance [CCD]) and type II a complete vertical displacement (>30% CCD). 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Dynamic instability of the acromioclavicular joint: A new classification for acute AC joint separation.
Background: Acute acromioclavicular (AC) dislocation is classified according to Rockwood (RW). Although of clinical relevance, dynamic horizontal translation (DHT) is not listed in this classification or in frequently used clinical evaluation tools. The aim of this study was (a) to evaluate vertical and horizontal AC joint instabilities and assess their combined occurrence and clinical appearance in a consecutive group of patients, as well as (b) to develop a new classification of acute AC joint dislocation.
Method: A consecutive group of 61 patients (seven female, 54 male) with a mean age of 34.5 years (18.9-60.1) were included in the study. All patients underwent posttraumatic clinical-Taft Score (TF), Acromioclavicular Joint Instability Score (ACJI), Constant Score (CS), Subjective Shoulder Value (SSV)-and radiological (bilateral anteroposterior stress and bilateral Alexander views) evaluation.
Results: According to the RW classification, the following AC dislocations were present: eight (13.1%) type I, nine (14.8%) type II, 22 (36.1%) type III, and 22 (36.1%) type V. Based on the clinical and radiographic results, a new classification is proposed: Type I instabilities show only a partial vertical displacement (≤30% coracoclavicular distance [CCD]) and type II a complete vertical displacement (>30% CCD). Both type I and II are further graded into none or partial (A) and complete DHT (B) as seen on bilateral Alexander views.
Conclusion: DHT can be found in low-grade instabilities and lead to inferior clinical results in the posttraumatic situation.
期刊介绍：
Zielsetzung der Zeitschrift
Die Zeitschrift Obere Extremität widmet sich der Versorgung von Verletzungen, Verletzungsfolgen und Erkrankungen im Bereich des Schulter- und des Ellenbogengelenks.
Frei eingereichte Originalien präsentieren Forschungsergebnisse aktueller Studien im Bereich der Schulter- und Ellenbogenchirurgie und fördern den wissenschaftlichen Austausch. Vielversprechende Studien, die derzeit durchgeführt werden, sind ebenso willkommen, wie Langzeitstudien, die bewährte Verfahren auf den Prüfstand stellen. Fallberichte beleuchten seltene Indikationen und schildern ungewöhnliche Behandlungsverläufe.
Umfassende Übersichtsarbeiten zu einem aktuellen Schwerpunktthema sind das Kernstück jeder Ausgabe. Im Mittelpunkt steht gesichertes Wissen mit hoher Relevanz für die tägliche Arbeit in der Schulter- und Ellenbogenchirurgie. Zusätzlich wird in speziellen Rubriken über innovative Behandlungsmaßnahmen, Probleme in der Begutachtung, berufspolitische Entwicklungen und Kongressaktivitäten berichtet.
Als gemeinsames Kommunikations- und Weiterbildungsforum für alle Chirurg*innen und Orthopäd*innen mit entsprechender Spezialisierung ist die Zeitschrift Obere Extremität zukunftsorientiert und schließt eine wichtige Lücke im orthopädisch-unfallchirurgischen Informationsangebot.
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The journal Obere Extremität (Upper Extremity) is dedicated to the treatment of injuries, consequences of injuries and diseases in the area of the shoulder and elbow joint.
Freely submitted originals present research results of current studies in the field of shoulder and elbow surgery and promote scientific exchange. Promising studies that are currently being carried out are welcome, as are long-term studies that put proven procedures to the test. Case reports illuminate rare indications and describe unusual courses of treatment.
Comprehensive reviews on a current focus topic are the core of each issue. The focus is on secured knowledge with high relevance for the daily work in shoulder and elbow surgery. In addition, special sections report on innovative treatment measures, problems in assessment, professional policy developments and congress activities.
As a joint communication and further education forum for all surgeons and orthopaedic surgeons with appropriate specialisation, the journal Obere Extremität is future-oriented and closes an important gap in the orthopaedic trauma surgery information offer.
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The journal Obere Extremität (Upper Extremity) follows the Committee of Publications Ethics (COPE) - Guidelines. Authors are recommended to register clinical trials they consider for publication in free, public clinical trial registries (e.g., www.clinicaltrials.gov, http://clinicaltrials.ifpma.org, http://isrctn.org, www.germanctr.de/online-Register_de.html) before publication. The registries are to be approved by the guidelines of the International Committee of Medical Journal Editors (ICMJE). Authors should include the name of the trial register and their clinical trial registration number at the end of their abstract.
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