Type III Acromioclavicular dislocations: Treatment options

Vasco Marques, A. C.

Objective: The purpose of this study is to evaluate and discuss treatment options for type III acromioclavicular joint dislocation, trying to standardize treatment decisions, particularly: conservative vs. surgical, acute vs. chronic phase and arthroscopic or open surgery.
 
Data Source: The articles were obtained searching MEDLINE using the following keywords: "acromioclavicular dislocation" or "acromioclavicular separation". We selected articles published from 2000 onward, which related exclusively to the treatment of type III injuries.
 
Data Synthesis: The evaluation of the Constant scores of different the papers reviewed, showed higher values for patients treated surgically, particulary in the acute phase (90,4-97pts vs. 80.7pts). However, it only has relevant statistically significance for the group of athletes and heavy manual workers. With regard to the subject shoulder evaluation, which attempts to objectify the satisfaction and return to the previous function, the difference in values is even more pronounced, when opting for surgical treatment in the acute phase, through arthroscopy, regardless of the technique used (82,5%-96% vs 77,6%).
 
Conclusions: The conservative approach is still considered good practice in the general population however, athletes and heavy manual workers surgery in the acute phase revealed the best option. The arthroscopy, because of its greater accuracy in anatomical reconstruction and the benefits of minimally invasive surgery, appears to offer advantages over classical open surgery.
 
 
Keywords: Orthopedics; acromioclavicular dislocations; rockwood type III acute treatment; shoulder arthroscopy;


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