Distal clavicular excision: a detailed functional assessment

Distal clavicular excision is commonly performed for a number of clinical conditions. The results of the procedure are not well described. Using the Constant, American Shoulder and Elbow Surgeons (ASES), University of California at Los Angeles (UCLA) and Neer scoring systems, the medium term results of distal clavicular excision were assessed. Over an 8 year period, 39 patients underwent distal clavicular excision for conditions other than acromioclavicular instability (subluxation or dislocation). A single technique was employed. A retrospective study was performed of all 18 patients who could be contacted. In those cases patient satisfaction was universal. Pre-operative pain was severe in 16 patients (89%) and moderate in two (11%). Following surgery, five (28%) were free from pain, 10 (55%) had only mild or occasional pain, and three (17%) reported moderate pain. The difference between pre-operative and postoperative levels of pain was highly significant (P < 0.001). However, continuing difficulties with work (59%), sleeping (55%) and activities of daily living (59%) were reported. Ten of 14 (71%) wishing to return to sporting activities were able to do so without restriction. Neither shoulder strength nor range of movement was fully restored following surgery, which relieved pain but did not restore normality. This series may facilitate subsequent assessment of arthroscopic distal clavicular excision.