[Current aspects and new techniques in dislocation of the shoulder joint]

Area of Science:

• Orthopedics
• Sports Medicine
• Traumatology

Background:

• Acromioclavicular (AC) joint dislocations represent 12% of shoulder injuries, frequently affecting young, active individuals.
• The widely used Rockwood classification categorizes injuries from I to VI based on severity and vertical displacement.
• Current limitations in the Rockwood classification include inadequate assessment of horizontal instability, leading to ongoing debate and research.

Purpose of the Study:

• To present a comprehensive review of the current evidence regarding the diagnosis of AC joint dislocations.
• To critically evaluate existing AC joint injury classifications, highlighting their strengths and weaknesses.
• To summarize and discuss the various therapeutic options for AC joint injuries, with a focus on Type III lesions.

Main Methods:

• Systematic review of existing literature on AC joint dislocations.
• Analysis of diagnostic modalities and their effectiveness.
• Comparison of different classification systems for AC joint injuries.
• Evaluation of conservative and operative treatment strategies based on current evidence.

Main Results:

• Conservative treatment is standard for Type I and II AC joint injuries; operative treatment is generally recommended for Type IV-VI injuries.
• There is a lack of consensus regarding the optimal treatment strategy for Type III AC joint lesions, with ongoing debate between conservative and surgical approaches.
• The current classification systems may not fully capture the complexity of AC joint instability, particularly horizontal components.

Conclusions:

• Further research is needed to refine AC joint injury classification and establish clear treatment guidelines, especially for Type III injuries.
• A better understanding of horizontal instability is crucial for improving treatment outcomes.
• This review provides an evidence-based overview to aid clinicians in managing AC joint dislocations.