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The coracoclavicular ligament connects the clavicle to the coracoid process of the scapula. [1] It is not part of the acromioclavicular joint articulation, but is usually described with it, since it keeps the clavicle in contact with the acromion. It consists of two fasciculi, the trapezoid ligament in front, and the conoid ligament behind. [2]
A Type II AC separation involves complete tearing of the acromioclavicular ligament, as well as a partial tear (but not a full tear) of the coracoclavicular ligaments. [5] This often causes a noticeable bump on the shoulder and partial or incomplete dislocation. [11] [5] This bump is permanent. The clavicle is unstable to direct stress ...
The patient should be supine with the hips flexed to 45 degrees, the knees flexed to 90 degrees and the feet flat on table. The examiner positions himself by sitting on the examination table in front of the involved knee and grasping the tibia just below the joint line of the knee.
As always, compare the test in the opposite knee. [4] [5] [12] Dial Test (anteromedial rotation test)- This test should be executed with the patient lying both supine and prone. When the patient is supine, the knees must be flexed 30° off the table. The thigh is then stabilized and the foot externally rotated.
Another form of evaluation that may be used in case physical examination and MRI are inconclusive is laximetry testing (i.e. arthrometry and stress imaging), which involve applying a force to the leg and quantifying the resulting displacement of the knee. [34] These medical devices basically replicate manual tests but offer objective ...
Dial Test (posterolateral rotation test) - The dial test can be performed with a patient lying supine or prone. With the patient supine and the knees flexed 30° off the table, stabilize the thigh and externally rotate the foot. As the foot rotates, watch for external rotation of the tibial tubercle of the affected knee compared to the healthy ...
The procedure is done to replace the coracoclavicular ligaments with the coracoacromial ligament. [2] There is currently no "gold standard" surgery to repair acromioclavicular separations, and many surgeries have been created. However, this is one of the more common fixes. The original surgery is described as follows.
While maintaining internal rotation, a valgus force is applied to the knee while it is slowly flexed. If the tibia's position on the femur reduces as the knee is flexed in the range of 30 to 40 degrees or if there is an anterior subluxation felt during extension the test is positive for instability. Pivot-shift is not straightforward to perform.