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
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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


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SLIDE 1

AC SC Case 79 year old active female fell while skiing

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SLIDE 2

“These do well without surgery”

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SLIDE 3

Questions:

  • 1. Treatment:

– A. Operative – B. Non-operative

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SLIDE 4

Questions

  • 1. Operative Treatment Choices:
  • A. Transacromial Fixation
  • B. Suture anchor(s)
  • C. Plate
  • D. Plate + CC fixation
  • E. Coracoclavicular fixation
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SLIDE 5

2 weeks later

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SLIDE 6

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

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SLIDE 7

Questions:

  • 1. Treatment:

– A. Operative – B. Non-operative

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SLIDE 8

Questions

  • 1. Operative Treatment Choices:
  • A. Transacromial Fixation
  • B. Suture anchor(s)
  • C. Plate
  • D. Plate + CC fixation
  • E. Coracoclavicular fixation
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SLIDE 9

CC Fixation

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SLIDE 10

8 weeks postop – clinically healed

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SLIDE 11

Case 2

  • 20 year old quarterback tackled and thrown on to one of

his shoulders and sustained a significant injury

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SLIDE 12

20 yo with football injury

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SLIDE 13

Weighted views

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SLIDE 14

20 yo with football injury

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SLIDE 15

20 yo with football injury

Cross body adduction AP radiographs

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SLIDE 16

20 yo with football injury

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SLIDE 17

20 yo with football injury

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

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SLIDE 18

AC-SC Case 3

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SLIDE 19

52 yo tri-athlete bike accident

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SLIDE 20
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SLIDE 21

AC-SC Case 4

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SLIDE 22

28 yo s/p bilateral clavicle fxs/MVA

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SLIDE 23
  • 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

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SLIDE 24
  • Emergent debredment
  • f HO
  • IM fixation of the

fracture

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SLIDE 25
  • 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