Acromioclavicular, Coracoclavicular and Medial Coracoclavicular Ligaments Assessment in Acromioclavicular Dislocation.

Autor: Filho RB; Hospital do Servidor Público Estadual de São Paulo (HSPE), IAMSPE, São Paulo, SP, Brasil., Freitas MM; Hospital do Servidor Público Estadual de São Paulo (HSPE), IAMSPE, São Paulo, SP, Brasil., Nunes RHR; Hospital do Servidor Público Estadual de São Paulo (HSPE), IAMSPE, São Paulo, SP, Brasil., Tenor Junior AC; Hospital do Servidor Público Estadual de São Paulo (HSPE), IAMSPE, São Paulo, SP, Brasil., Costa MPD; Hospital do Servidor Público Estadual de São Paulo (HSPE), IAMSPE, São Paulo, SP, Brasil., Roberto RA; Hospital do Servidor Público Estadual de São Paulo (HSPE), IAMSPE, São Paulo, SP, Brasil.
Jazyk: angličtina
Zdroj: Revista brasileira de ortopedia [Rev Bras Ortop (Sao Paulo)] 2021 Dec 07; Vol. 56 (6), pp. 777-783. Date of Electronic Publication: 2021 Dec 07 (Print Publication: 2021).
DOI: 10.1055/s-0040-1719088
Abstrakt: Objective  To study the anatomy of the medial coracoclavicular ligament and assess the contribution of the acromioclavicular, coracoclavicular and medial coracoclavicular ligaments to the stability of the acromioclavicular joint. Methods  Twenty-six shoulders from 16 fresh cadavers were dissected after placement in dorsal recumbency with a 15-cm cushion between the shoulder blades. An extended deltopectoral approach was performed proximally and medially, followed by plane dissection and ligament identification. The acromioclavicular and coracoclavicular distances were measured using points previously marked with a millimeter caliper. Six of these specimens were submitted to a biomechanical study. The acromioclavicular ligament, the coracoclavicular ligament and the medial coracoclavicular ligament were sectioned sequentially, and a cephalic force of 20 N was applied to the lateral clavicle. The acromioclavicular and coracoclavicular distances were measured in each of the ligament section stages. Results  The right medial coracoclavicular ligament presented, on average, 48.9 mm in length and 18.3 mm in width. On the left side, its mean length was 48.65 mm, with a mean width of 17.3 mm. Acromioclavicular, coracoclavicular and medial coracoclavicular ligament section resulted in a statistically significant increase in the coracoclavicular distance and posterior scapular displacement. Conclusion  The medial coracoclavicular ligament is a true ligamentous structure found in all dissected shoulders. Our results showed that the scapular protraction relaxed the medial coracoclavicular ligament, while scapular retraction tensioned it; in addition, our findings demonstrate that this ligament contributes to the vertical and horizontal stability of the acromioclavicular joint.
Competing Interests: Conflito de Interesses Os autores declaram não haver conflitos de interesse.
(Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)
Databáze: MEDLINE
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