Comprehensive functional analysis of shoulders following complete acromioclavicular separation

The purpose of this study was to examine the results of the two major methods of treatment of complete acromioclavicular separation: surgery and nonsurgical techniques. Twenty male patients with complete acromioclavicular separation within the preceding 13 months were retrospectively examined and tested for recovery of shoulder strength and function. Comparisons were conducted between 10 of the patients who had been treated nonsurgically (Group 1), and 10 who had been treated surgically (Group 2). An additional group of 10 uninjured male subjects as controls was also tested for comparison of strength between dominant and nondominant limbs (Group 3). All of the patients were tested for strength of both shoulders using the Kin-Com isokinetic dynamometer, for shoulder flexibility using the Leighton flexometer, and for grip strength using a standard grip dynamometer. A questionnaire concerning patient evaluation of the injury was also administered to all of the subjects. The majority of strength and flexibility tests showed no significant differences between the nonsurgical and surgical groups. The nonsurgical group was statistically superior to the surgical group in the following test scores: eccentric abduction (fast speeds), concentric external rotation (slow speeds), eccentric external rotation (fast), eccentric abduction (slow), and flexibility in external rotation. These findings generally indicated that the nonsurgical treatment of a third-degree acromioclavicular separation is superior in restoring normal shoulder function in the 1st year following injury.