Acromioclavicular third degree dislocation: surgical treatment in acute cases

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Traumatology

Background:

• Management of acute Rockwood type III acromioclavicular joint (ACJ) dislocation is debated.
• This study compares conservative versus surgical treatment in young athletes.

Purpose of the Study:

• To compare clinical and radiological outcomes of conservative and surgical treatments for acute type III ACJ injuries in active participants under 35.
• To analyze patient satisfaction, aesthetic results, and shoulder function after a minimum 24-month follow-up.

Main Methods:

• Retrospective evaluation of 72 patients with acute type III ACJ dislocations (2006-2011).
• Group A: 25 patients treated conservatively. Group B: 30 patients treated surgically with TightRope™ system.
• Clinical scores (Constant, UCLA, ASES, ACJI) and radiographic measurements were assessed.

Main Results:

• Subjective parameters favored the surgical group; ACJI scores were significantly better in the surgical group (87.9 vs 72.4).
• Radiographic evaluations showed significant improvements in the surgical group.
• Objective scores (Constant, ASES, UCLA) were similar between groups (P > 0.05).

Conclusions:

• Surgical treatment yielded better subjective and radiographic results for type III ACJ dislocations.
• Despite improved subjective outcomes, objective scores did not differ significantly, questioning the routine use of surgery.