journal
https://read.qxmd.com/read/37716736/acromioclavicular-clavicle-and-sternoclavicular-injuries-in-athletes
#1
EDITORIAL
Katherine J Coyner
No abstract text is available yet for this article.
October 2023: Clinics in Sports Medicine
https://read.qxmd.com/read/37716735/acromioclavicular-clavicle-sternoclavicular-strutting-horizontally
#2
EDITORIAL
Mark D Miller
No abstract text is available yet for this article.
October 2023: Clinics in Sports Medicine
https://read.qxmd.com/read/37716734/atraumatic-sternoclavicular-joint-instability-prevalence-etiology-and-management
#3
REVIEW
Wade Gobbell, Christopher M Edwards, Samuel R Engel, Katherine J Coyner
Sternoclavicular joint instability is a rare complaint in the orthopedic clinic, but patients can experience chronic pain and functional impacts. Causes of instability may be posttraumatic, infectious, autoimmune, degenerative, or secondary to generalized laxity. Conservative treatment is the initial approach to management and involves activity modification, physical therapy, oral nonsteroidal anti-inflammatory drugs, and corticosteroid injections. Surgery is indicated when conservative treatment does not manage symptoms...
October 2023: Clinics in Sports Medicine
https://read.qxmd.com/read/37716733/traumatic-sternoclavicular-dislocations-in-athletes-diagnosis-indications-for-surgical-reconstruction-and-guide-for-return-to-play
#4
REVIEW
Leah Brown, Lisa M Tamburini
Injuries to the sternoclavicular (SC) joint are rare, however, when they occur prompt recognition, evaluation, and treatment are crucial. SC joint injuries can occur following high-energy mechanisms such as motor vehicle collisions and contact sports. Injury to the SC joint can be evaluated with the use of plain radiographs as well as computed tomography. If an injury to the SC joint is suspected, injury to vital mediastinal structures must be evaluated. SC joint dislocations can be treated by either closed reduction or open reduction and stabilization...
October 2023: Clinics in Sports Medicine
https://read.qxmd.com/read/37716732/operative-management-for-displaced-distal-clavicle-fractures
#5
REVIEW
Mihir M Sheth, Theodore B Shybut
This article reviews techniques and outcomes of surgical fixation for distal clavicle fractures. Near 100% union has been reported for several techniques. The most common are locked plating, coracoclavicular fixation and a combination of plating with CC fixation. Hook plates are useful for particular fracture patterns, but there can be complications specific to this implant. Low-profile constructs are favored due to the high rates of symptomatic hardware. Fixation of subacute and chronic injuries can provide reliable functional improvements, but is inferior to acute fixation...
October 2023: Clinics in Sports Medicine
https://read.qxmd.com/read/37716731/classification-of-distal-clavicle-fractures-and-indications-for-conservative-treatment
#6
REVIEW
Jayson Lian, Ferdinand J Chan, Benjamin J Levy
Management of distal clavicle fractures depends on a clear understanding of the injury's proximity to the ligamentous attachments joining the clavicle and scapula. Various classification systems have been proposed to guide treatment. Despite this, controversy between operative and nonoperative management remains for certain fracture patterns. Patient-specific factors, concomitant injuries, fracture characteristics (displacement, shortening, and rotation) should all be considered when deciding on treatment. When nonoperative management is indicated, patients should be immobilized in a sling for 2 weeks, followed by gradual range of motion, and strengthening exercises...
October 2023: Clinics in Sports Medicine
https://read.qxmd.com/read/37716730/dual-versus-single-plate-fixation-of-clavicle-fractures-understanding-the-rationale-behind-both-approaches
#7
REVIEW
Lisa M Tamburini, Benjamin C Mayo, Cory Edgar
Clavicle fractures are a common injury resulting from a high-energy force, such as a fall onto the shoulder, motor vehicle accident, or sporting activity. Although some clavicle fractures may be treated nonoperatively, operative treatment results in higher union rates and faster return to activity. Here we discuss the operative treatment options for plating of clavicle fractures; specifically, a single plate placed either superiorly or anteriorly or two plates placed orthogonally. Because both techniques provide adequate stability, fracture and patient characteristics should guide the surgical decision making regarding single versus dual plating of clavicle fractures...
October 2023: Clinics in Sports Medicine
https://read.qxmd.com/read/37716729/clavicle-nonunion-and-malunion-surgical-interventions-for-functional-improvement
#8
REVIEW
Alirio J deMeireles, Natalia Czerwonka, William N Levine
Clavicle nonunion and malunion are relatively uncommon but, when symptomatic, can result in pain and dysfunction that requires surgical intervention. Various reconstructive and grafting techniques are available to achieve stable fixation and union. In the setting of persistent nonunion, vascularized bone grafting may be necessary. A thorough understanding of the patient's type of nonunion and potential for healing is crucial for achieving satisfactory results because is thoughtful preoperative planning and surgical fixation...
October 2023: Clinics in Sports Medicine
https://read.qxmd.com/read/37716728/getting-athletes-back-on-the-field-management-of-clavicle-fractures-and-return-to-play
#9
REVIEW
Wade Gobbell, Christopher M Edwards, Samuel R Engel, Katherine J Coyner
This chapter provides an overview of the prevalence of clavicle fractures in athletes. The evaluation and management of clavicle fractures in athletes is summarized, including surgical considerations, rehabilitation protocols, and return to sport guidelines. In this population, high rates of union are observed, but careful timing of return to sport is paramount to optimize performance and prevent reinjury.
October 2023: Clinics in Sports Medicine
https://read.qxmd.com/read/37716727/midshaft-clavicle-fractures-when-is-surgical-management-indicated-and-which-fixation-method-should-be-used
#10
REVIEW
Myra Trivellas, Jocelyn Wittstein
For displaced midshaft clavicle fractures, operative treatment either with open reduction and plate fixation or with intramedullary fixation has been shown to provide earlier return to work and sport, improved functional outcomes, greater patient-reported satisfaction with appearance, and significantly decreased incidence of nonunion and malunion when compared with conservative treatment. Operative intervention is not without risks associated with surgery. Shared decision-making with the patient and understanding patient goals allows surgeons to recommend a management option that the patient will be comfortable with and will follow to achieve a satisfactory outcome...
October 2023: Clinics in Sports Medicine
https://read.qxmd.com/read/37716726/surgical-pearls-and-pitfalls-for-anatomic-acromioclavicular-coracoclavicular-ligament-reconstruction
#11
REVIEW
Peter S Chang, Colin P Murphy, Ryan J Whalen, John M Apostolakos, Matthew T Provencher
Injuries to the acromioclavicular (AC) joint are common shoulder injuries in contact/collision athletes. There are a number of different surgical options that can be used to treat these injuries. The majority of these injuries can be treated nonoperatively with an early return to play for type I and II injuries. Surgical intervention and AC/CC (coracoclavicular) ligament reconstruction have excellent postoperative outcomes if complications can be avoided. This review will focus on the pearls and pitfalls for anatomic AC and CC ligament reconstruction for high-grade AC joint injuries...
October 2023: Clinics in Sports Medicine
https://read.qxmd.com/read/37716725/risk-for-fracture-with-acromioclavicular-joint-reconstruction-and-strategies-for-mitigation
#12
REVIEW
Nikolaos Platon Sachinis, Knut Beitzel
Acromioclavicular (AC) joint injuries are a common cause of shoulder pain, especially among athletes. Surgical reconstruction of the AC joint can lead to complications such as fracture of the coracoid process, clavicle or acromion, which can negatively affect the patient's outcome. The purpose of this review is to discuss the risk factors for fractures associated with AC joint reconstruction, as well as the strategies that can be used to mitigate this risk. Risk factors for fractures include low mineral density, coracoid/clavicle drilling, larger holes in the coracoid, and the number of tunnels used for reconstruction...
October 2023: Clinics in Sports Medicine
https://read.qxmd.com/read/37716724/arthroscopic-repair-and-reconstruction-of-coracoclavicular-ligament
#13
REVIEW
Jeffrey D Hassebrock, Daniel J Stokes, Tyler R Cram, Rachel M Frank
Acromioclavicular joint separations are common shoulder injuries that require prompt recognition, diagnosis, and treatment. Deciding on a treatment algorithm relies on a detailed knowledge of anatomy and a thorough understanding of the specific functional demands of the patient in question. When a repair or reconstruction is indicated, arthroscopic assistance can be a helpful tool to ensure a safe, anatomic reconstruction that minimizes morbidity and maximizes the potential return to high-level function.
October 2023: Clinics in Sports Medicine
https://read.qxmd.com/read/37716723/open-anatomic-coracoclavicular-ligament-reconstruction-for-acromioclavicular-joint-injuries
#14
REVIEW
E Lyle Cain, David Parker
Open reconstruction of the coracoclavicular (CC) and acromioclavicular (AC) ligaments results in excellent reduction of severely displaced AC dislocations, most commonly Grades III and V. Anatomic CC reconstruction through clavicular bone tunnels can prevent vertical instability, whereas the addition of an acromial limb of the graft can increase horizontal stability. Autograft tendon is preferred in the young athletic group of collision sports participants, although allograft has had acceptable results. Accessory fixation may be placed to protect the graft during healing, or for severe instability, especially for athletes involved in contact sports...
October 2023: Clinics in Sports Medicine
https://read.qxmd.com/read/37716722/diagnosis-and-nonoperative-treatment-of-acromioclavicular-joint-injuries-in-athletes-and-guide-for-return-to-play
#15
REVIEW
Brittany Olsen, Bonnie Gregory
Injury to the acromioclavicular (AC) joint accounts for approximately 40% to 50% of all shoulder injuries. In contact sports, the prevalence of AC joint injury increases. This injury is frequently encountered and treated by fellowship-trained as well as general orthopedic surgeons. As such, it is important to understand the diagnostic and treatment pathways for AC joint disruption. The treatment pathways in athletes may be different from those in the general population. This article will focus on the diagnosis and nonoperative treatment of AC joint injuries in athletes...
October 2023: Clinics in Sports Medicine
https://read.qxmd.com/read/37716721/acromioclavicular-joint-anatomy-and-biomechanics-the-significance-of-posterior-rotational-and-translational-stability
#16
REVIEW
Nicholas P J Perry, Nozimakhon K Omonullaeva, Blake M Bacevich, Robert J Nascimento, Evan A O'Donnell, Mark D Price, Augustus D Mazzocca
The shoulder girdle extends from the sternoclavicular joint to the scapular stabilizing muscles posteriorly. It consists of 3 joints and 2 mobile regions. The shoulder girdle is statically stabilized by the acromioclavicular and coracoclavicular capsuloligamentous structures and dynamically stabilized by the trapezius, deltoid, and deltotrapezial fascia. During humerothoracic elevation, the clavicle elevates, protracts, and rotates posteriorly through the sternoclavicular joint while the scapula tilts posteriorly and rotates upward...
October 2023: Clinics in Sports Medicine
https://read.qxmd.com/read/37716720/management-of-acromioclavicular-joint-injuries-a-historic-account
#17
REVIEW
Liam A Peebles, Ramesses A Akamefula, Matthew J Kraeutler, Mary K Mulcahey
There has been a rapid evolution in best practice management of acromioclavicular (AC) joint injuries. AP, Zanca, scapular Y, and dynamic axillary radiographic views provide optimal visualization of the joint and may assess for the presence of horizontal AC instability. Severity of AC joint pathology is classified according to the 6-tier Rockwood scoring system. Over 160 surgical techniques have been described for AC joint repair and reconstruction in the last decade; as a result, determining the optimal treatment algorithm has become increasingly challenging secondary to the lack of consistently excellent clinical outcomes...
October 2023: Clinics in Sports Medicine
https://read.qxmd.com/read/37208065/on-the-field-emergencies-in-athletics-it-takes-a-team
#18
EDITORIAL
Eric McCarty, Sourav Poddar, Alex Ebinger
No abstract text is available yet for this article.
July 2023: Clinics in Sports Medicine
https://read.qxmd.com/read/37208063/acute-compartment-syndrome-in-the-athlete
#19
REVIEW
Omar Farah, Ghassan Farah, Salma Mumuni, Elan Volchenko, Mark R Hutchinson
In sports, acute compartment syndrome (ACS) develops following lower limb fracture, with subsequent high intracompartmental pressures and pain out of proportion to the physical examination. A prompt diagnosis is the key to a successful outcome in patients with ACS. The goal of treatment of ACS, namely decompressive fasciotomy, is to reduce intracompartmental pressure and facilitate reperfusion of ischemic tissue before onset of necrosis. A delay in diagnosis and treatment may result in devastating complications, including permanent sensory and motor deficits, contractures, infection, systemic organ failure, limb amputation, and death...
July 2023: Clinics in Sports Medicine
https://read.qxmd.com/read/37208062/fractures-and-dislocations-on-the-playing-field-which-are-emergent-and-what-to-do
#20
REVIEW
James T Stannard, James P Stannard
High-energy injuries, including fractures and dislocations, are occurring with increasing frequency in athletic competitions with the increasing size and speed of players. Common fractures and dislocations will be discussed in this article. We will evaluate emergent versus routine injuries and discuss appropriate treatment at the athletic venue. Fractures that can be seen with athletic activities include cervical spine; knee osteochondral fractures; tibia, ankle, and clavicle. Dislocations that will be considered include knee, patella, hip, shoulder, sternoclavicular joint, and proximal interphalangeal joint of the finger...
July 2023: Clinics in Sports Medicine
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