AC SC Case 79 year old active female fell while skiing These do - PowerPoint PPT Presentation

AC SC Case 79 year old active female fell while skiing

“These do well without surgery”

Questions: 1. Treatment: – A. Operative – B. Non-operative

Questions 1. Operative Treatment Choices: A. Transacromial Fixation B. Suture anchor(s) C. Plate D. Plate + CC fixation E. Coracoclavicular fixation

2 weeks later

“I thought these were supposed to do well without surgery???”

Questions: 1. Treatment: – A. Operative – B. Non-operative

Questions 1. Operative Treatment Choices: A. Transacromial Fixation B. Suture anchor(s) C. Plate D. Plate + CC fixation E. Coracoclavicular fixation

CC Fixation

8 weeks postop – clinically healed

Case 2 • 20 year old quarterback tackled and thrown on to one of his shoulders and sustained a significant injury

20 yo with football injury

Weighted views

20 yo with football injury

20 yo with football injury Cross body adduction AP radiographs

20 yo with football injury

20 yo with football injury 19 year follow-up: Patient is now a practicing orthopedic surgeon and feels his right shoulder is “normal”

AC-SC Case 3

52 yo tri-athlete bike accident

AC-SC Case 4

28 yo s/p bilateral clavicle fxs/MVA

• 3 mos post-injury • Developed severe neurovascular claudication R arm • No axillary or musculocutaneous nerve function • Massive HO about fx involving axillary artery and brachial plexus

• Emergent debredment of HO • IM fixation of the fracture

• IM pinning and debredment of HO • Fell on to left shoulder dislodging pin • Revised to anterior, locked LC-DCP plate • HO morcelized and used as bone graft • Pending hardware removal due to pain • Surgery postponed due to drug abuse issues