Original articleGrade I and II acromioclavicular dislocations: results of conservative treatment
Section snippets
Materials and methods
Thirty-seven consecutive patients were treated at our institution between 1993 and 1997 for an acute grade I and II AC joint sprain. Of these patients, 4 were excluded (3 were lost to follow-up and 1 sustained a further AC injury), leaving a series of 33 patients (16 patients with grade I AC sprain and 17 patients with grade II). The mean age at the time of trauma was 25 years (range, 23-32 years). Of the patients, 29 (85%) were athletes, and trauma occurred in 29 (of the 33) (85%) during
results
The results are summarized in Table II. Between the accident and the last follow-up, 9 of 33 patients (27%) (7 grade II and 2 grade I) required surgery. Isolated open distal clavicle resection was performed in 6 cases, 4 times for osteoarthrosis (1 grade I and 3 grade II AC joint sprains) and 2 times for a painful osteolysis of the distal clavicle (1 grade I and 1 grade II AC joint sprains). In 3 cases a transposition of the medial half of the coracoacromial ligaments on the distal clavicle was
Discussion
Our study revealed a surprisingly high rate of complications (need for further surgery, pain, radiographic changes) after grade I and II AC joint sprain treated conservatively. This is in contradiction with the current literature, which suggests that grade I and II AC sprains have a good prognosis, although percentages are not reported, and are not associated with joint instability.1, 15 Many authors advise conservative treatment12, 14, 15, 16, 17, 21, 24, 28 with nonsteroidal antiinflammatory
References (30)
- et al.
Arthroscopic resection of the distal clavicle
Orthop Clin North Am
(1993) - et al.
Acromioclavicular joint injuries
Orthop Clin North Am
(2000) Fractures and ligamentous injuries of the clavicle and its articulation
J Bone Joint Surg Am
(1967)Athletic injuries about the shoulder in throwing and body contact sports
Clin Orthop
(1962)- et al.
Evaluation of the acromioclavicular joint following first- and second-degree sprains
Am J Sports Med
(1978) - et al.
A clinical method of functional assessment of the shoulder
Clin Orthop
(1987) The fate of the acromioclavicular joint in athletic injuries
Am J Sports Med
(1981)- et al.
Biomechanical study of the ligamentous system of the acromioclavicular joint
J Bone Joint Surg Am
(1986) - et al.
Dislocation acromioclavicular jointfollow-up study of 35 unreduced acromioclavicular dislocations
Am J Sports Med
(1977)
Management of old neglected posttraumatic acromioclavicular joint instability and arthrosis
Orthopade
The evaluation and treatment of the injured acromioclavicular joint in athletes
Am J Sports Med
Osteolysis of the acromial end of the clavicle following trauma
Br J Radiol
Acromioclavicular joint injuries and the distal clavicle fractures
J Am Acad Orthop Surg
Cited by (134)
Qualitative and Quantitative Anatomic Descriptions of the Coracoclavicular and Acromioclavicular Ligaments: A Systematic Review
2022, Arthroscopy, Sports Medicine, and RehabilitationCriteria for return to play after operative management of acromioclavicular joint separation: a systematic review
2022, JSES Reviews, Reports, and TechniquesThe Acromioclavicular Joint
2022, Skeletal Trauma of the Upper ExtremityImaging of traumatic shoulder injuries – Understanding the surgeon's perspective
2022, European Journal of Radiology Open