Surgical treatment of acromioclavicular dislocation: a review of 39 patients

Results after the operative treatment of 39 total (Type III) acromioclavicular (AC) dislocations are reported. The operation consisted of suture of the acromioclavicular and coracoclavicular ligaments and transfixion of the AC joint with an AO/ASIF malleolar screw passed through the acromion into the lateral end of the clavicle. The screw was removed at an average of six weeks after the operation. In 36 patients re-examined after a mean of 4 years, the overall results were good in 92 per cent of cases. The range of flexion and abduction was excellent (over 170 degrees) in 90 per cent. Stress radiographs revealed persisting subluxation of the AC joint in 6 patients and persisting dislocation in 1. Signs of osteoarthrosis were seen in 4 patients and signs of osteolysis in 12. Radiological signs of osteolysis correlated well with incongruity of the AC joint but not with the clinical function. Radiological signs of osteoarthrosis in the AC joint, however, correlated with a poor clinical result: all patients with a fair or poor clinical result had signs of osteoarthrosis in the AC joint. Except for one, all patients returned to their preoperative occupations within an average of two months.