Current Concepts in the Diagnosis and Management of Acromioclavicular Dislocations

Post, Melvin

doi:10.1097/00003086-198511000-00029

Cited by 65 publications

(31 citation statements)

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“…Common classifications for AC dislocations are the Allman [5], Tossy et al [6] and Rockwood et al [7] classifications. Allman Types I and II are widely accepted as best managed conservatively [3,8] and there seems to be a consensus that type IV-VI should be treated operatively [7,[9][10][11]. The best treatment for Rockwood type III dislocations is, despite numerous trials and reviews, still unclear.…”

Section: Introductionmentioning

confidence: 99%

Operative or conservative treatment in patients with Rockwood type III acromioclavicular dislocation: a systematic review and update of current literature

Korsten

Gunning

Leenen

2013

International Orthopaedics (SICOT)

100

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Purpose Despite previous studies the management of Rockwood type III acromioclavicular (AC) dislocations remains controversial and the debate continues about whether patients with Rockwood type III AC injuries should be treated conservatively or operatively. In this study, we will review the current literature and present an overview of the outcome of conservative versus operative treatment of Rockwood type III dislocations. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was used to conduct this review. A systematic search was performed in the Pubmed, Cochrane library, Embase, Scopus and Cumulative Index to Nursing and Allied Health Literature databases. Titles and abstracts were screened using predefined criteria and articles were critically appraised on relevance and validity. Results After critical appraisal eight articles were included in the study. The objective and subjective shoulder function outcome was better in the operative group, especially in young adults, though the rate of complications and radiographic abnormalities were higher. The rehabilitation time was shorter in the conservative group, however the cosmetic outcome was worse. Conclusions This review showed no conclusive evidence for the treatment of Rockwood type III AC dislocations. Overall, physically active young adults seem to have a slight advantage in outcome when treated operatively.

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Section: Introductionmentioning

confidence: 99%

Operative or conservative treatment in patients with Rockwood type III acromioclavicular dislocation: a systematic review and update of current literature

Korsten

Gunning

Leenen

2013

International Orthopaedics (SICOT)

100

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“…Conservative treatment for type III ACDs was successfully described on several studies. 4,11,[20][21][22][23] Despite of the studies mentioned above, conservative treatment for all cases of acute type-III ACD is indicated by only 4.2% of the respondents. Countless conservative treatment methods for full ACDs have been reported, including strapping with adhesive tape, slings, strapping, supports, traction, compressive bandage and plastered casts.…”

Section: Discussionmentioning

confidence: 99%

“…1 Tossy et al 2 described three types of acromioclavicular dislocations based on ligament injuries, physical and X-ray examination, and Rockwood 3 , modified that classification by adding three other types, according to clavicular dislocation degree and orientation. Treatment has been controversial [4][5][6] , since the first published reports 7 . Over 50 immobilization techniques and over 30 kinds of surgical treatment 8 have been described with variable results.…”

Section: Introductionmentioning

confidence: 99%

Estudo transversal sobre o tratamento das lesões acrômioclaviculares agudas

et al. 2009

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The objective of the present transversal study is to check how Brazilian orthopedists treat these injuries, their criteria for choosing the treatment, results and complications. Methods: During the 6th Brazilian Congress of Shoulder and Elbow Surgery (CBOC) and the 38th Brazilian Congress of Orthopaedics and Traumatology (CBOT) 507 questionnaires were distributed (148 CBOC and 359 CBOT), with 478 being considered for analysis. Results: Regarding type-I and -II ACIs, most of the respondents use traditional non-surgical methods. On the other hand, for type-IV, V and VI injuries, 475 (99.4%) of the respondents indicate surgical methods. Concerning type-III injuries, there is no consensus in the selection between traditional and surgical treatment for 386 (80.7%) respondents, with the most important factor for selecting a given treatment method being the patient's level of sports practice and age. Conclusion: There is no consensus regarding type-III ACIs, and the selection of the best treatment method is made according to patient's individual characteristics. However, current literature shows a trend towards non-operative methods. Keywords: Acromioclavicular joint/lesions/surgery. Shoulder dislocation. Shoulder.All the authors state no potential conflict of interest concerning this article. 2 described three types of acromioclavicular dislocations based on ligament injuries, physical and X-ray examination, and Rockwood 3 , modified that classification by adding three other types, according to clavicular dislocation degree and orientation. Treatment has been controversial 4-6 , since the first published reports 7 . Over 50 immobilization techniques and over 30 kinds of surgical treatment 8 have been described with variable results. According to Rockwood et al classification, types I and II should be treated by conventional methods, while types IV, V VI should be operated, because they present strong deviations and associated muscle injuries. 9 However, type III dislocations -which are quite frequent -are usually controversial. 9-11The objective of the present study is to check which criteria are adopted by Brazilian orthopaedic doctors when addressing these injuries. METHODOLOGYCongress attendants participated on this study on a volunteer basis, and the questionnaires were randomly distributed among the participants. Questionnaires filled by non-doctors, foreign participants, by those who had previously filled them, or incomplete questionnaires were excluded from this study. 507 participants were interviewed. 359 filled the forms during the 38th Brazilian Congress of Orthopaedics and Traumatology (CBOT) in Fortaleza/ 2006, and 148 responded the questionnaire during the 6th Brazilian Congress of Shoulder and Elbow (CBOC) in Goiânia/ 2006. The number of interviews required for a significant sample combining both congresses is 124 (n= (1.96 x standard deviation / 0.25 standard deviation)^2 = 62), considering a 95% confidence interval and a standard deviation corresponding to four times the sample error . This wa...

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“…Controversy regarding the surgical indications for AC joint separations was present long before Rockwood's classification [25,26,33]. When Rockwood expanded the three-part classifications of Allman [1] and Tossy et al [32], it was accepted among surgeons that Types I and II were treated nonoperatively, that Types IV, V, and VI might best be treated by surgery, and that management of Type III injuries was controversial.…”

Section: Limitationsmentioning

confidence: 99%

Classifications in Brief: Rockwood Classification of Acromioclavicular Joint Separations

Gorbaty

Hsu

Gee

2017

Clinical Orthopaedics &Amp; Related Research

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Current Concepts in the Diagnosis and Management of Acromioclavicular Dislocations

Cited by 65 publications

References 0 publications

Operative or conservative treatment in patients with Rockwood type III acromioclavicular dislocation: a systematic review and update of current literature

Operative or conservative treatment in patients with Rockwood type III acromioclavicular dislocation: a systematic review and update of current literature

Estudo transversal sobre o tratamento das lesões acrômioclaviculares agudas

Classifications in Brief: Rockwood Classification of Acromioclavicular Joint Separations

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