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Acromioclavicular lesions in children
The American Journal of Sports Medicine
|May 1, 1981
Summary
Surgical treatment of complete acromioclavicular joint dislocations in children yields over 90% excellent results. Younger children (<13) often have distal clavicle fractures, requiring different management than older children with adult-type dislocations.
Area of Science:
- Orthopedic Surgery
- Pediatric Orthopedics
- Sports Medicine
Background:
- Complete acromioclavicular (AC) joint dislocations are less common in children than adults.
- Misdiagnosis can occur in younger children, who may present with distal clavicle fractures instead.
Purpose of the Study:
- To evaluate the outcomes of surgically treated complete AC joint dislocations in pediatric patients.
- To differentiate management strategies based on age and injury type in children.
Main Methods:
- Follow-up study of 25 children (ages 5-16) with surgically treated AC joint dislocations.
- Surgical techniques included pin fixation, Bosworth screw, and Mersilene taping.
- Patients were analyzed based on age, injury pattern, and treatment outcomes.
Main Results:
- Over 90% of patients achieved good or excellent outcomes with full, asymptomatic activity.
- No growth disturbances were observed.
- Two patients (cross-pinned) developed asymptomatic AC joint arthritis.
- Children under 13 frequently had distal clavicle fractures (20% misdiagnosed as AC dislocations).
Conclusions:
- Surgical treatment is effective for complete AC joint dislocations in children and adolescents.
- Age is a critical factor in diagnosis and treatment, with distinct approaches for pre-pubertal and adolescent patients.
- Conservative management is recommended for distal clavicle fractures in younger children.