Surgical treatment of complete acromioclavicular dislocations

Forty-four patients, ranging in age from 17 to 57 years (average, 32), were evaluated an average of 4 years (range, 2 to 9) after surgical reconstruction for Allman-Tossy Grade III acromioclavicular dislocations. Twenty-seven patients underwent repair for acute injuries (< 3 weeks after injury) and 17 patients underwent reconstructions for chronic injuries (> 3 weeks). Coracoclavicular fixation with heavy nonabsorbable sutures was used to correct superior displacement in all cases. In addition, transfer of the coracoacromial ligament to the distal clavicle was performed in 15 of the 27 early repairs and 17 of the 17 late reconstructions. Overall, 26 of 27 (96%) early repairs and 13 of 17 (77%) late reconstructions achieved satisfactory results. There was a trend for better results and return to sports or heavy labor with early repairs; however, this was not statistically significant (P = 0.065). When the results of early repairs were compared with those of late reconstructions performed more than 3 months after injury, the results of the shoulders undergoing early repair were significantly better (P < 0.01). Overall, 39 of 44 (89%) patients achieved a satisfactory result. Surgical reconstruction for acromioclavicular dislocation provides reliable results including use of the arm for sports or repetitive work.