A Comparison Between Conservative and Operative Treatment of Acute Acromioclavicular Dislocation

M, Rosenorn; Eb, Pedersen

doi:10.3109/17453677408989121

Cited by 55 publications

(22 citation statements)

References 7 publications

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“…So, these conclusions are not necessarily applicable to other techniques, but the trends presented here are consistent with other investigations on type III ACJ injury operated on with other techniques. 2,3,6,7,13,15 In addition, the time of follow-up was short in the conservatively treated group; thus, a future effect on the outcome of any of the variables analyzed cannot be ruled out.…”

Section: Discussionmentioning

confidence: 94%

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Clinical and radiologic outcomes of surgical and conservative treatment of type III acromioclavicular joint injury

Calvo¹,

López-Franco²,

Arribas³

2006

Journal of Shoulder and Elbow Surgery

133

105

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Section: Discussionmentioning

confidence: 94%

“…15 The joint was considered to be reduced when there was no displacement compared with the uninvolved side, subluxed when there was a moderate (less than 50%) upward displacement of the clavicle relative to the acromion, and dislocated if the displacement was greater than half of the height of the ACJ.…”

Section: Methodsmentioning

confidence: 99%

Clinical and radiologic outcomes of surgical and conservative treatment of type III acromioclavicular joint injury

Calvo¹,

López-Franco²,

Arribas³

2006

Journal of Shoulder and Elbow Surgery

133

105

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“…Over the past 30 years, the literature has supported nonoperative management. [19][20][21][22][23][24][25][26][27] This would allow for delayed surgical stabilization in the event of failed conservative measures. A recent systematic review of the literature concluded that nonoperative treatment of grade III AC separations is superior to surgical treatment.…”

Section: Treatmentmentioning

confidence: 99%

Practical Management of Grade III Acromioclavicular Separations

Trainer

Arciero

Mazzocca

2008

Clinical Journal of Sport Medicine

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Acromioclavicular joint (AC) injuries are common in the young athletic population. There is general agreement that grade I and grade II separations are best managed nonoperatively, whereas grades IV to VI warrant surgical stabilization. In contrast, considerable controversy exists surrounding the best method of treatment for grade III AC separations. The trend in recent literature is toward the initial nonoperative management of these injuries. However, consideration of other factors such as type of sport, timing of injury relative to athletic season, or the throwing demands in an injured dominant arm may play a role in the decision to treat grade III injuries operatively or nonoperatively. We offer a protocol algorithm for treating grade III AC separations for managing this controversial injury.

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“…[245] Early surgical intervention for intermediate separations is a common recommendation in a select subgroup of patients (heavy manual laborers, overhead workers and elite sportsmen who require the ability to throw) for optimum outcome. [35–8] This is supported by the literature findings that approximately 17% to 28% of patients treated non operatively will have disability with pain, weakness, fatigue, impingement and ACJ instability. [369–14] There are however, no scientific papers which prove the superiority of acute intervention compared to delayed treatment in this subgroup.…”

Section: Introductionmentioning

confidence: 80%

Clinical results of coracoacromial ligament transfer in acromioclavicular dislocations: A review of published literature

Sood

Wallwork

Bain

2008

Int J Shoulder Surg

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Acromioclavicular joint dislocations are common injuries, which typically occur with trauma in young men. Treatment recommendations for these injuries are highly variable and controversial. There are greater than 100 surgical techniques described for operative treatment of this injury. One of the most widely recommended methods of surgical reconstruction for acromioclavicular joint dislocations is to utilize the coracoacromial ligament for stabilization of the distal clavicle. Several modifications of this procedure have been described which have involved adjunct coracoclavicular fixation or fixation across acromioclavicular joint. Although the literature is replete with descriptive papers, there is paucity of studies evaluating the surgical outcome of this procedure. We systematically reviewed the English language published literature in peer reviewed journals (Medline, EMBASE, SCOPUS) and assigned a level of evidence for available studies. We critically reviewed each paper for the flaws and biases and then evaluated the comparable clinical outcomes for various procedures and their modifications. The published literature consists entirely of case series (Level IV evidence) with variability in surgical technique and outcome measures. On review there is low level evidence to support the use of coracoacromial ligament for acromioclavicular dislocation but it has been associated with high rate of deformity recurrence. Adjunct fixation does not improve clinical results when compared to isolated coracoacromial ligament transfer. This is in part because of the high incidence of fixation related complications. Similar results are reported with coracoacromial ligament reconstruction for acute and chronic cases. The development of secondary acromioclavicular joint symptoms with distal clavicle retention is poorly reported with the incidence rate varying from 12% to 32%. Despite this, the retention or excision of distal clavicle did not affect overall clinical results except in the patients with pre existing acromioclavicular joint osteoarthritis who have inferior results with retention of distal end of clavicle. Further well designed clinical trials with validated outcome measures are required to fully evaluate the clinical results of this procedure.

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A Comparison Between Conservative and Operative Treatment of Acute Acromioclavicular Dislocation

Cited by 55 publications

References 7 publications

Clinical and radiologic outcomes of surgical and conservative treatment of type III acromioclavicular joint injury

Clinical and radiologic outcomes of surgical and conservative treatment of type III acromioclavicular joint injury

Practical Management of Grade III Acromioclavicular Separations

Clinical results of coracoacromial ligament transfer in acromioclavicular dislocations: A review of published literature

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