By Hans-Jörg Oestern, Otmar Trentz, Selman Uranues
There at the moment is a transparent tendency to increasingly more unintended accidents in aged humans, in activity accidents and automobile crashes additionally in international locations which lately joined the ecu Union and applicants to affix the eu Union. sufferers anticipate first-class practical effects even after severe accidents. yet not like this improvement, Trauma surgical procedure as an self sustaining box, isn't but demonstrated in all ecu international locations. accordingly, it sort of feels essential to assemble a booklet that covers the cutting-edge in Trauma surgical procedure. The booklet additionally serves to harmonise the perform of Trauma surgical procedure in the eu Union, and to arrange for the examination of the U.E.M.S.
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Extra info for Bone and Joint Injuries: Trauma Surgery III
P. projection of the glenohumeral joint as well as Y-view or transaxillary views are taken. To evaluate the acromioclavicular joint directly, the Zanca view should be used by tilting the center-beam 30–45° caudocranial, aiming on the acromioclavicular joint (Zanca 1971). The Alexander view (Y-view with maximum arm adduction) helps to verify subluxation in acromioclavicular joints (Alexander 1954). p. projections comparing both sides should be taken, using 5–10 kg weights. Transaxillary views are highly recommended to diagnose a horizontal instability.
CT scan and scintigraphy (arthritis) can be performed but are of lesser importance than an MRI. Early osteolysis (repetitive trauma) or rheumatoid arthritis can be diagnosed through MRI. In acute acromioclavicular dislocations, a huge number of missed injuries (15 % SLAP lesion, 5 % fractures, 4 % rotator cuff tears) were found . Acromioclavicular separations are classified by Tossy (1963) and Rockwood (1984). Kraus et al. published a new measurement tool for instability of the acromioclavicular joint, the acromioclavicular joint instability score (ACJI), in 2010.
The acromioclavicular joint is a diarthrodial joint, built by the acromion on its lateral aspect and the lateral clavicle on its medial margin. A fibrocartilaginous intraarticular disc is located between the osseous segments. K. Horst, MD (*) • T. -C. 4 Diagnostics When the patient has suffered from a traumatic event, a direct blow to the adducted arm is frequently described. -J. Oestern et al. 1007/978-3-642-38388-5_4, © Springer-Verlag Berlin Heidelberg 2014 35 36 K. Horst et al. 1 Rockwood classification  Type Type I: Type II: Type III: Type IV: Type V: Type VI: Description Sprain of the acromioclavicular or coracoclavicular ligament Subluxation of the acromioclavicular joint associated with a tear of the acromioclavicular ligament; coracoclavicular ligaments is intact Dislocation of the acromioclavicular joint with injury to both acromioclavicular and coracoclavicular ligaments Dislocation of the acromioclavicular joint with injury to both acromioclavicular and coracoclavicular ligaments.