Rockwood grade I and II acromioclavicular injuries: as benign as commonly believed?

Abstract

Abstractthe acromioclavicular (AC) joint is the articulation between the distal clavicle and the acromion process of the scapula. As the upper limb moves, passive motion of the AC joint occurs in three planes, with the AC and coracoclavicular ligaments providing stability. injuries are common, particularly during contact sports, and are classified using Rockwood's system. Grade i (sprain) and ii (rupture) injuries only affect the AC ligaments and are generally managed conservatively. However, recent reports have indicated that long-term outcomes after these injuries are poor, perhaps due to an inadequate period of immobilization preventing complete ligamentous healing.

Triple-Endobutton and clavicular hook: A propensity score matching analysis

“…When Fukuda studied the anatomy and function of the acromioclavicular joint, it was found that the coracoclavicular ligament maintains the vertical stability of the acromioclavicular joint, and the conical ligament and the trapezoidal ligament are opposite in opposing forces and maintain a balance [ 10 ]. Klassen conducted research and analysis on the ligaments around the acromioclavicular joint and found that the acromioclavicular joint complex was the strongest, followed by the tapered ligament, and the trapezoid ligament the weakest [ 11 ]. The detailed anatomical structure and biomechanical research provide sufficient basis for the treatment of acromioclavicular joint dislocation that is not rigidly fixed, elastic, and more in line with anatomy and human biomechanics [ 12 ].…”

“…Previous study indicated that conservative treatment is usually used for patients with Rockwood classification I and II [ 10 , 11 , 12 ]. When the acromioclavicular joint dislocation is of Rockwood type III and above, the acromioclavicular ligament and the coracoclavicular ligament are completely broken, causing shoulder pain and restriction of activities, thereby seriously affecting the daily activities of patients [ 13 ].…”

“…The CMS includes shoulder pain (15 points), daily life (10 points, including normal work, entertainment, sleep is affected), the final height of the affected side’s hand (10 points), the active range of movement of the affected side’s shoulder joint, including front Flexion (10 points), abduction (10 points), internal rotation (10 points), and external rotation (10 points), and abduction muscle strength (25 points). Full score is 100 points [ 11 ].…”

Restoring Horizontal Stability of the Acromioclavicular Joint: Open Acromioclavicular Ligament Reconstruction and Repair With Semitendinosus Allograft

“…nonsteroidal anti-inflammatory drugs, immobilization, physical therapy), but several studies have reported poor long-term outcomes in terms of pain and disability. 15 , 16 , 17 In 2003, Mouhsine et al. 17 evaluated 33 patients with grade I and II AC separations treated by conservative measures, including ice application, analgesics, and immobilization.…”

“…nonsteroidal anti-inflammatory drugs, immobilization, physical therapy), but several studies have reported poor long-term outcomes in terms of pain and disability. [15][16][17] In 2003, Mouhsine et al 17 evaluated 33 patients with grade I and II AC separations treated by conservative measures, including ice application, analgesics, and immobilization. The authors reported 27% of patients (9 of 33; 7 grade II and 2 grade I) failing conservative treatment and requiring subsequent surgery an average of 26 months after injury.…”