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The biomechanical influence of the deltotrapezoid fascia on horizontal and vertical acromioclavicular joint stability

  • Arthroscopy and Sports Medicine
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Many studies have investigated the biomechanical influence of the acromioclavicular (AC) and coracoclavicular (CC) ligaments on the stability of the acromioclavicular joint (ACJ). It has been shown that augmentation of the CC ligaments alone can result in residual horizontal instability. Our hypothesis was that the DTF would have a significant stabilizing effect on horizontal ACJ stability.

Materials and methods

In a biomechanical in vitro study a sequential injury of the ACJ was created on eight shoulders from full body, which were placed in an upright sitting position. The translation and rotation of the clavicle were measured in relation to the acromion using an optical navigation system in various states during thoracic–humeral elevation, abduction, and horizontal adduction. The three states were: an intact shoulder, complete sectioning of the AC ligaments, and a circular lesion of the DTF.

Results

Compared to the intact state we found a significant increase in anterior rotation of the clavicle of 1.11° (p = 0.012) and a tendency in lateral translation of 2.71 mm (p = 0.017) in relation to the acromion, with a combined lesion of AC ligaments and DTF. No significant differences were found between the intact state and the isolated dissected AC ligaments as well in adduction as elevation.

Conclusion

A combined lesion of the AC ligaments and the DTF resulted in a quantitatively small but significant increase in anterior rotation and a tendency in lateral translation of the clavicle in relation to the acromion. These differences were quantitatively small, so that the clinical relevance of the stabilization effect of combined AC ligaments and DTF injuries is questionable.

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Acknowledgments

The study was funded by the German speaking society of arthroscopy and joint surgery (AGA, Porzellangasse 8/23, 1090 Vienna, Austria).

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Medical School Hannover, Anna-von-Borries Straße 1-7, 30625, Hannover, Germany

    M. F. Pastor, A. K. Averbeck, T. Smith, L. Claassen & M. Wellmann

  2. Laboratory of Biomechanics and Biomaterials, Medical School Hannover, 30625, Hannover, Germany

    B. Welke

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  1. M. F. Pastor
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  2. A. K. Averbeck
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  3. B. Welke
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Correspondence to M. Wellmann.

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Pastor, M.F., Averbeck, A.K., Welke, B. et al. The biomechanical influence of the deltotrapezoid fascia on horizontal and vertical acromioclavicular joint stability. Arch Orthop Trauma Surg 136, 513–519 (2016). https://doi.org/10.1007/s00402-015-2389-1

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  • DOI: https://doi.org/10.1007/s00402-015-2389-1

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