Acute acromioclavicular dislocations treated by fixation of the joint and ligament repair or reconstruction

We reviewed 55 patients, median age 34 years, who had had acute complete acromioclavicular dislocation treated by transient acromioclavicular fixation with a Knowles pin and ligament repair by suturing or reconstruction of the superior acromioclavicular ligament with transfer of the coracoid end of the coracoacromial ligament onto the clavicle. At followup examination 50 patients showed at least a satisfactory result. Five cases, two of which had had subsequent resection of the distal end of the clavicle, were classified as poor, mainly because of pain, even though the functional result was good in three. Reconstruction of the superior acromioclavicular ligament, although it improved the anatomic result, was shown to be of no advantage and may even have caused discomfort. The numerous radiological findings of residual subluxation or dislocation, deformity of the distal end of the clavicle, soft tissue calcification and osteoarthritis or pathological physical findings did not correlate significantly with the clinical outcomes. In general this operation gave results comparable with those achieved by other operative methods. It is useful if surgery is preferred to conservative treatment.