Clinical and Instrumental Diagnosis of Dislocations of the Clavicle Acromial End

Abstract

Dislocations of the acromial end of the clavicle (AEC) are a very common traumatic injury. They account for 6.8% to 26.1% of all dislocations and rank third place after shoulder and forearm dislocations. AEC dislocation is usually caused by a fall on the shoulder followed by downward traction of the upper limb. This traumatic injury is more often diagnosed in men mostly of working age, which determines the social significance of this injury. In the structure of acute traumatic injuries in the shoulder girdle, the rate of AEC dislocations is more than 12%. An important stage of diagnosis is establishing the type of damage, which determines the choice of method and treatment approach. The definition of horizontal instability, which is determined by using instrumental survey methods, plays a significant role. The objective: to analyze the level of diagnosis of AEC dislocations by development a clinical diagnostic algorithm. Materials and methods. During the study, our own experience in the diagnosis and treatment of 375 patients with AEC dislocations over a period of almost thirty years was used, and the literature sources of Pubmed, Up-to-date, Scopus, Web of Science, MedLine, The Cochrane Library, EMBASE, Global Health, Cyber Leninka. Results. It was found that to diagnose and determine the type of damage are necessary points to conduct a targeted bilateral examination using the obtained data. X-ray examination with certain projections is a mandatory and sufficiently informative instrumental method. Sonographic and MRI examinations objectify the place and type of damage. Their validity is appropriate in the differential diagnosis of the pathology of the AEC and the shoulder joint. Conclusions. A “Clinical-instrumental diagnostic algorithm for AEC dislocations” has been developed, which will reduce the number of diagnostic errors, that will ensure timely treatment of patients with this pathology.