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Minimally Invasive Surgery for Shoulder AC Joint Dislocation: A New Option to Avoid a Second Surgery
52-Year-Old Man Receives Treatment for Shoulder Dislocation After a Car Accident
A 52-year-old man who had been in a car accident sought medical attention after experiencing persistent left shoulder pain and an inability to raise his arm. He had previously been treated in another hospital's emergency room. He consulted Dr. Chen Wei-Jen, an orthopedic specialist at the China Medical University Hsinchu Hospital.
After conducting X-rays, Dr. Chen Wei-Jen diagnosed the patient with a shoulder acromioclavicular (AC) joint dislocation. He discussed treatment options with the patient and recommended an arthroscopic procedure to realign the joint. The surgery lasted approximately 1.5 hours, and the patient was discharged after a 2-day hospital stay. He received ongoing outpatient follow-up care and rehabilitation therapy, which enabled him to regain normal shoulder function.
Dr. Chen Wei-Jen explained that shoulder AC joint dislocations often occur in patients who have sustained injuries from accidents or falls. Mild cases can be managed conservatively, with initial protection and subsequent rehabilitation, allowing patients to recover normal shoulder function. However, severe dislocations, like the patient's, require surgical intervention. Typically, an open surgical approach with a 7-10 cm incision is used to realign the AC joint. This involves the use of a clavicle hook plate to stabilize the clavicle and scapula, facilitating the healing of damaged ligaments and joint capsules. While effective, this method may subject the shoulder to excessive pressure on the clavicle, potentially leading to future shoulder pain or even clavicular fractures. To address these concerns, a second surgery to remove the metallic implant is recommended 4-6 months after the initial procedure, posing risks such as anesthesia and additional incision-related discomfort.
In contrast, arthroscopic surgery offers several advantages. It allows for effective realignment of the AC joint through small incisions, resulting in less postoperative pain. The most significant benefit is that it eliminates the need for a second surgery to remove metallic implants, providing patients with an alternative surgical option.