Improved identification of unstable acromioclavicular joint injuries in a clinical population using the acromial center line to dorsal clavicle radiographic measurement.
J Shoulder Elbow Surg
; 29(8): 1599-1605, 2020 Aug.
Article
em En
| MEDLINE
| ID: mdl-32147334
BACKGROUND: Accurate classification and subsequent management of acromioclavicular (AC) joint injuries remains a contentious topic. The updated Rockwood classification acknowledges "stable IIIA" and "unstable IIIB" injuries, a watershed accepted by ISAKOS and important in guiding clinical management. Traditionally, the coracoclavicular distance is used to classify these injuries, despite well-documented limitations. This study aimed to evaluate displacement in AC joint injuries by measuring both coracoclavicular (CC) distance and the newly proposed acromial center line to dorsal clavicle (AC-DC) distance, in a cohort of patients, and correlate the results between the 2 measurements and relationship to Rockwood grade. MATERIALS AND METHODS: Ninety consecutive cases of AC joint injury were evaluated radiographically for Rockwood classification, CC distance on anteroposterior radiographs, and AC-DC distance on Alexander view radiographs. Inter- and intraobserver reliability for each measurement was calculated as well as correlation between the 2 measurement types and the degree to which each measurement accurately represented the Rockwood classification. RESULTS: Although both CC and AC-DC measurements showed very high inter- and intraobserver reliability, the CC distance systematically underestimated the degree of AC joint displacement when compared with the AC-DC measurement as the severity of injury increased, particularly in the presence of posterior horizontal displacement such as that seen in Rockwood IV injuries. CONCLUSION: The AC-DC measurement and use of the Alexander view provides the clinician with a more realistic appreciation of true AC joint displacement, especially in defining watershed cases (ie, IIIA/IIB/IV) and may better inform the decision-making process regarding management options and recommendations.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Articulação Acromioclavicular
/
Acrômio
/
Clavícula
/
Luxações Articulares
/
Processo Coracoide
/
Instabilidade Articular
Tipo de estudo:
Diagnostic_studies
/
Guideline
/
Prognostic_studies
Limite:
Adolescent
/
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article