Grade III shoulder dislocation of AC joint

[ac-ligaments]

HI ALL
/ Gareth & mantisgb

( Sorry about my spelling - from Denmark )
I´ve used hours & hours searching for the best solution for my 3. luxation
Training, training in 8 month - absolutely no progress past 5 months.
For me "conservative management" sucks.

To all new ACJ victims ? for your own sake ? take the following article under serious consideration: http://www.ejbjs.org/cgi/reprint/17/4/1005.pdf
So sad my hospital had the conservative opinion. The article is to late for me ? my ligaments is degenerated.
In my humble nonDoctor opinion ? even grade 2 & lucky grade 3 ? victims would never loose anything getting original ligaments restored !!!
-----------------------------------------------------------------------------------------
Back to Gareth´s OP - earlier posted in this Thread
? i'm very interested in a follow-up on that kind of surgery.
Hope Gareth appears with some new info.
What the name is for that OP ? and who performs it ???

Never heard about "false ligament pinned in between the colar bone and shoulder" - but why not !!! About time for some new methods ? like the sentence
? must be the no. 1 place to make the shoulder stable.
Tried to Google it ? no luck.

Totally impressed - bench press 55 kg. 7 weeks after the operation.
( think its a bad idea even after 27 weeks with a Weaver-Dunn )
-----------------------------------------------------------------------------------------
Never liked the Weaver-Dunn, but there is a new modified technique ? again very poor information.
Up to date it looks logic to do it that way ? only transfer ½ the ligament.
?avoiding sacrifice of the coracoacromial arch? - Also an interesting solution: http://www.ejbjs.org/cgi/content/abstract/89/11/2408
-----------------------------------------------------------------------------------------
Also like to hear news from mantisgb, who had the ?Nottingham Surgilig reconstruction?
http://www.injuryupdate.com.au/forum...urgilig&page=3
( after a Weaver-Dunn failure ) - Method described here:
http://www.opnews.com/articles/138/articles.php#3
-----------------------------------------------------------------------------------------
Like to make a new thread ? dont know how - mostly interested in new ACJ OP techniques !!!
Summary:
Gareths ?false ligament pinned in between.....?
The Weaver/Dunn alike method: ?Conjoined Tendon Transfer?
mantisgb artificial ligament: ?Nottingham Surgilig reconstruction?

Anybody please have any update/info on those 3 OP methods ???

[gckmd]

since i have enjoyed reading the threads posted here and elsewhere on the net i have decided to contribute my own experience. took a nasty spill over the handlebars of my road bike last 5 days ago and "dislocated" my left acromioclavicular (ac) joint completely (grade 3). since i am an orthopaedic surgeon i knew immediately what had happened after feeling the bump on my shoulder. have since had xrays and even an mri (to r/o rc tear) . the pain is tolerable and although i cancelled my surgery schedule this week i have been working in the clinic and hope to begin operating by next week.

regarding the decision for surgery, i already knew that most (if not all) grade 3 injuries can be treated non operatively. still i am bothered by the prospect of a "bump" and perhaps a weaker & occ painful shoulder. yet i have not found anything to justify early surgery since the results of non-op care are generally very good and one can always do something about it later if it continues to be a bother. maybe it is just my desire to be "normal" again( not that surgery will make the shoulder normal-just look more normal).

still considering my options but need to decide soon. will keep this updated for future sufferers benefit.

[gckmd]

that article was written in 1935!!!

[sar]

Hello all, I came off my motorbike on the race track 10 days ago and landed on my outstretched arm at speed, dislocating the AC joint - grade 3 with clear bump deformity, separation of around 5-8mm or so which is easily seen in xrays where the clavicle end is raised up by about 2/3's of its width. Pain is strong but no piankillers, range of movement is good and two doc's have said to just leave it alone and let it get better on its own. I'm not bothered by the bump but I do play tennis at a fairly high competitive/tournament level and want to return to that.

Im going to start physio but would also like to know if anyone can recommend a good orthopedic shoulder specialist surgeon in the Sydney area, pref west/Parramatta/Liverpool area. I have read that if you're going to have surgery its best to have it done within 3 weeks of the injury happening.

[Scottah]

lol @ the 1935 article, I realised the same thing after reading it all...

gkmcd, have you decided your course of action yet?

I saw an ortho surgeon today... my separation is 1.5cm ... and he has said the op would basically be just for cosmetic reasons...

It has been 2 weeks for me, and I'm seeing good progress. I can lift my arm all the way up but it does NOT feel good, very delicate...

I'm going to go for non surgical management.

[HYPE]

I just had ac surgery...now i have 6 weeks of wearing this big uncomfortable sling!!!...but without surgery the space will fill with scar tissue and thats about it...and as for the joint! Without surgery there is no chance that it will jump back into place!!!...

[arconvert]

What type of surgery did you have HYPE?

I ditched my sling after about 7 days and just put my hand in my pocket to support it.

I had the hook plate surgery and had a lot of swelling for a month or so, but I think most of the swelling was probably due to the trauma caused by the crash that dislocated the joint.

[hallissd]

Hi,
I found this forum and just wanted to contribute to it as when i first dislocated my ac joint I wanted to find out more about my options and found it to be different for everyone. I first dislocated my ac joint during a gaelic football match after a collision with another player. Turns out it was a grade three dislocation. As I'm playing high intensity football and am also in a sports course it was important that I could heal it as quick as possible. I first went to the orthopaedic specialist and he informed me that in many cases the grade three would not require surgery, however he said that if I wanted to return to sport and considering my career area he said that surgery would probably be a better option as leaving it heal naturally was a long strengthening process and that it is susceptible to dislocating again. I then returned and asked to have the surgery as I was eager to get back, bascially what they insert is a clavicle hook plated that pushes the dislocation back into place. the surgery took about an hour and was left out of the hospital later that day. To be honest the first two weeks after the insertion of the plate I was in desperate pain, particularly at night and trying to sleep on it. Throughout the length of time the plate is in there you will experience pain but once the dislocation is back into place the pain eases off. I was in a sling and immobilised for 6 weeks after surgery. A thing I noticed during the time the plate was in, that my range of motion was increasing but still wouldn't be able to raise my arm up fully as obviously with the plate it restricts movement, a few times id be messing aswel kicking around and going out that I feared a number of times id done damage to it. I also noticed a sharp tiny lump underneath the scar and also a purple fluid based lump on the scar. I didn't know what these were and I thought that the sharp lump was a metal piece of the plate or something. I returned to my orthopaedic consultant and he assured me I hadnt done any damage, that the sharp lump was a ball of stitches that had gathered under the skin but that after a while would dissolve. The purple fluid lump was benign he assured me and that it was not a sign of infection. 8 weeks later I had got an appointment to have the plate removed, which was yesterday, after the surgery it actually feels a lot better, it was a lot less painful than when i went in beforehand. I am in a sling for a week but going back then to remove stitches. The doctor informed me that the lump may come back but it wont be as noticable as when i first did it as the scar tissue will help prevent that. He also said I could go back playing football in about 5 -6 weeks which I was happy enough with as prior to surgery he told me it would be longer. Overall i inujred it in early february and hope to be back the end of june so outlook was 5 months...hopefully

[Brandden]

Well this information is quite helpful for me to get knowledge about preventing shoulder injury. I would definitely say that this is the nice place to find appropriate information.