BACKGROUND: Arthroscopic stabilization of torn coracoclavicular (CC) ligaments gained popularity recently. However, loss of reduction after the operation and complications unique to this technique involving tunnel placement through the distal clavicle and coracoid process are concerns. The purpose of this study was to report intraoperative and early postoperative complications associated with this procedure. METHODS: This study retrospectively evaluated 18 consecutive patients who had undergone arthroscopic stabilization for torn CC ligaments between 2014 and 2015. The indications for surgery were acute or chronic acromioclavicular dislocation and acute fracture of the distal clavicle, associated with CC ligament disruption. Clinical outcomes were evaluated with the American Shoulder and Elbow Surgeons (ASES) and the University of California, Los Angeles (UCLA) scores. Intra- and postoperative complications and reoperations were investigated. RESULTS: There were six female and 12 male patients with a mean age of 47 years (range, 22 to 86 years). At a mean follow-up of 17 ± 10 months (range, 10 to 28 months), the mean ASES score was 88.8 ± 19.9 and the mean UCLA score was 30.9 ± 5.2. Intraoperatively, seven complications developed: breach of lateral cortex of the coracoid process in five patients, medial cortex of the coracoid process in one, and anterior cortex of the clavicle in one. Postoperative complications developed in eight patients: four ossifications of the CC interspace, four tunnel widening of the clavicle, one bony erosion on the clavicle, and one superficial infection. A loss of reduction was found in six patients. Reoperation was performed in three patients for loss of reduction in two and superficial infection in the other. CONCLUSIONS: Arthroscopic CC stabilization resulted in high rates of intraoperative and early postoperative complications. Most of them were related to the surgical technique involving bone tunnel placement in the coracoid process and the clavicle.
California ; Clavicle ; Dislocations ; Elbow ; Female ; Follow-Up Studies ; Humans ; Ligaments ; Male ; Postoperative Complications ; Reoperation ; Retrospective Studies ; Shoulder ; Surgeons

BACKGROUND: Spitz nevus and malignant melanoma have common features clinically and histologically, and in some cases it is impossible to distinguish between the two. Heat shock proteins (HSPs) serve to protect cells, and are activated by cell injury. Some HSPs are shown to be elevated in many types of cancers. Previous studies have reported the expression of heat shock protein in association with melanoma; however, a similar relationship with Spitz nevi has never been investigated. OBJECTIVE: This study was designed to measure the expression pattern of HSP 105 in both Spitz nevi and melanomas. METHODS: The specimens of 4 of Spitz nevi and 10 of malignant melanomas were analyzed for heat shock protein 105 expression through immunohistochemical staining. RESULTS: Immunohistochemical examination of HSP 105 showed strong expression in malignant melanoma specimens. On the other hand, weak expression was observed in Spitz nevus specimens. The degree of expression of HSP 105 showed a statistically significant difference (p<0.05). CONCLUSION: These findings provide the possibility of using HSP 105 as a effective marker for differentiating between Spitz nevi and malignant melanomas. In support of this, HSP 105 is considered to be a tumor-associated antigen of malignant melanoma.
Hand ; Heat-Shock Proteins ; Melanoma ; Nevus ; Nevus, Epithelioid and Spindle Cell