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[Acute acromioclavicular dislocations].

N Riand1, C Sadowski, P Hoffmeyer

  • 1Clinique et policlinique d'orthopédie et de l'appareil moteur, Hôpital Universitaire de Genève.

Acta Orthopaedica Belgica
|February 17, 2000
PubMed
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Acromioclavicular (AC) joint dislocations are common shoulder injuries. While grades I-II and IV-VI have clear treatment paths, grade III management remains debated, with conservative care often yielding acceptable results and allowing for later surgery if needed.

Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Traumatology

Background:

  • Acromioclavicular (AC) dislocations constitute over 10% of acute shoulder girdle injuries.
  • The injury typically results from direct shoulder impact with the arm adducted, causing sequential rupture of AC and coracoclavicular (CC) ligaments.
  • Rockwood classification outlines 6 grades of AC joint injury severity.

Purpose of the Study:

  • To review the diagnostic and management strategies for acromioclavicular dislocations.
  • To discuss the controversies surrounding the treatment of grade III AC dislocations.
  • To highlight the effectiveness of conservative management for certain AC joint injuries.

Main Methods:

  • Diagnosis is primarily based on physical examination, confirmed by radiological assessment (X-rays of the AC joint).

Related Experiment Videos

  • Treatment strategies are stratified by injury grade: conservative for I-II, surgical for IV-VI.
  • Grade III management involves evaluating conservative versus surgical options, considering patient factors.

    • Main Results:

    • Grade I and II AC dislocations are typically managed conservatively with arm immobilization for 3-4 weeks.
    • Grades IV, V, and VI dislocations generally undergo surgical fixation (AC pinning or CC screw fixation).
    • Functional outcomes for grade III AC dislocations are often comparable between surgical and conservative treatments, with conservative care offering faster recovery and options for secondary surgery.

    Conclusions:

    • Conservative treatment is often favored for grade III AC dislocations, especially given comparable functional results and the option for delayed surgical intervention.
    • The choice of operative technique for AC dislocations lacks a universally superior method.
    • Informed patient counseling regarding treatment outcomes and recovery is crucial for managing expectations.