POSTER ABSTRACTS - ISAKOS

E-poster #935
Habitual Inferior Subluxation of the Clavicle at
the Acromioclavicular Joint
Kazuhiko Kikugawa, Matsuyama, JAPAN, Presenter
Yu Mochizuki, Hiroshima, JAPAN
Mitsuo Ochi, Hiroshima, Hiroshima, JAPAN
Matsuyama Red Cross Hospital, Matsuyama,
Ehime, JAPAN
The traumatic acromioclavicular dislocation is
common injury, the clavicle most often dislocates
superiorly in relation to the acromion. But nontraumatic
acromioclavicular dislocation is quite
rare and the clavicle rarely dislocated inferiorly.
We report a rare case of habitual inferior
subluxation of the clavicle at the
acromioclavicular joint.
(Case report) A 14-year-old female, who had a 6-
years career of table tennis felt a pain on right
shoulder when she hit a ball at the top position
on her forehand. By moving her shoulder
backward and forward, he felt a click and a severe
pain. The clavicle dislocated beneath the
acromion when the shoulder was abducted at
from 20 degree to 90 degree. There were no other
sign of joint laxity. A-P roentgenograms and
cineradiograms in the dislocated position, the gap
between the clavicle and coracoid was lower
compared with the reduced position. Treatment
was by reconstruction of the acromioclavicular
joint using her palmaris longus tendon.
Postoperatively, there was good pain relief and
the subluxation of the acromioclavicular joint was
disappeared.
E-poster w/ Standard #936
Forced Shoulder Abduction and Elbow Flexion
Test: A New Simple Clinical Test to Detect
Superior Labral Injury in the Throwing
Shoulder
Shigeto Nakagawa, Osaka, JAPAN, Presenter
Minoru Yoneda, Osaka, Osaka, JAPAN
Naoko Mizuno, Osaka, Osaka, JAPAN
Yukioka Hospital & Osaka Kosei-nenkin Hospital,
Osaka, JAPAN
Although several provocation tests for detecting
superior labral injury of the shoulder have been
reported, some of the maneuvers involved are
complicated and diagnosis is still inaccurate. The
purpose of this report is to introduce our forced
shoulder abduction and elbow flexion test (forced
abduction test) along with an assessment of its
efficacy in the throwing shoulder by comparison
with other clinical tests. Fifty-four throwing
athletes who underwent arthroscopic surgery were
prospectively studied. Superior labral injury was
present in 24 cases (Snyder's classification was
type 2 in 17, type 3 in 2, type 2+3 in 4, and type
2+4 in 1), and there was loose attachment of the
superior labrum in 6. Several clinical tests were
performed preoperatively and the results were
recorded on our original chart. Then, the
condition of the superior labrum was examined
during arthroscopic surgery and the results of
these tests were compared with the arthroscopic
findings. The forced abduction test was classified
as positive when pain at the postero-superior
aspect of the shoulder on forced maximal
abduction was relieved or diminished by elbow
flexion. As results, the sensitivity, specificity, and
accuracy of the forced abduction test was 67%,
67%, and 67%, respectively. It was one of the
effective tests, along with the crank test and
O'Brien's test: (crank test: 58%, 72%, 66%,
O'Brien's test: 54%, 60%, 57%, respectively).
Furthermore, the results of the forced abduction
test showed a significant correlation with the
presence of superior labral injury (p=0.0275, chisquare
test). In conclusions, the forced abduction
test is a simple and effective method of
diagnosing superior labral injury in throwing
shoulders.
E-poster w/ Standard #937
Arthroscopic Distal Clavicle Resection in Subtle
Acromioclavicular Instability
Yon-Sik Yoo, Pohang, KOREA, Presenter
Gil-young Ahn, Pohang, Gyung-buk, KOREA
Il-hyun Nam, Pohang, Gyung-buk, KOREA
Gi-hyuk Moon, Pohang, Gyung-buk, KOREA
Ho-hyun Yoon, Pohang, Gyung-buk, KOREA
Pohang St.Mary hospital, Pohang, KOREA
Distal clavicle resection is reported to be a
successful method of addressing various level of
pain originating in the acromioclavicular(AC)
joint. However, recent clinical studies on
arthroscopic distal clavicle resection for treatment
of subtle instability tells a different story. Many
articles have been written by those who doubt the
use of arthroscopic distal clavicle resection for
unstable AC joint. Failure to attain good results
have led them to consider surgery to stabilized
the AC joint. But reconstruction of AC ligament is
practically impossible because of the lack of data
on previous reconstruction attempts and difficulty
in making new AC ligament due to their short in