الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 144 |  |  |
| | | from | 144 | | |
Abstract
ACJ dislocation is a common clinical shoulder injury, mostly caused by direct violence, more common in men. Treatment of ACJ injuries continues to be controversial among clinicians, with much disagreement on the optimal intervention for variable severity of the injury. Currently, there are over 100 techniques of surgical fixation of the ACJ described in the literature. There are some discrepancies between approaches for acute and chronic injuries. Also, there is little consensus on which method is the most effective. The main objective of this study was to evaluate the outcomes of ligamentous reconstruction of ACJ disruption by a semitendinosus tendon graft. It was a prospective study carried out at the orthopedic department of Menoufia university hospital, Samanoud central hospital & Al-Mahalla general hospital. (21) Participants were selected from patients admitted to the orthopedic department from October 2018 to April 2020. The main results of the study revealed that:
The mode of injury was classified under 3 categories. In RTA accidents there were (12) patients represented about (57.1%). On Slipping & falling injuries, there were (7) patients represented about (33.3%). In sports activities, there were (2 ) patients represented about (9.5%).
According to the Rockwood classification system, there were (10) patients classified as a type III ACJ disruption which represented about (47.6 %), (4) patients type IV i.e. (19 %) & (7) patients type V i.e. (33.4%).
UCLA scores ranged from (25:35) with a mean ± SD of (30.33 ± 3.44) points. The excellent results i.e. from (34:35) points were (4) patients with a percentage of (19 %). The majority of cases scored good results i.e. from (28:33) points, they were (12) patients and represented about (57.2%). There were (5) cases resulted in fair results i.e. from (21:27) points, they represented about (23.8%). There were no poor results.
There was a highly statistically significant difference between the preoperative & immediate post-operative percentage of dislocation relative to the normal side as the p-value was < 0.001, while was a non-significant difference between immediate post-operative & the 6th-month post-operative percentage of dislocation relative to the normal side (i.e. residual subluxation) as p-value was > 0.05.
There were only (4) hypertensive patients represented about (19%) & there were no other systemic diseases.
The operative time range varied from (80:120 ) min with a mean of (94.52± 12.14 ) min. also the post-operative stay ranged from (1:4) days with a mean of (2.19±0.93) days. Finally, the follow-up period ranged from(6:12) months with a mean of (9.52±2.21) months.
There was no statistically significant correlation between the UCLA score with Rockwood classification.
There was no statistically significant correlation between the UCLA score with associated systemic disease (HTN) and associated injuries.
There was a statistically significant correlation between the UCLA score with complications.
There was a statistically significant correlation between the UCLA score with age as the p-value was < 0.05*.
Based on our findings, we reached to that despite there is an ongoing debate on the gold standard for surgical management of high-grade ACJ injuries, the anatomic reconstruction of the CC and AC ligaments with an autologous semitendinosus tendon graft provided good and reliable clinical and radiological results with a low failure rate at short-term follow-up.