Type III acromioclavicular dislocation: Mid term results after operative and non-operative treatment

L Álvarez-Álvarez; M Cela-López; E González-Rodríguez; A García-Perez; M Rodríguez-Arenas; M Castro-Menéndez

doi:10.1016/j.recot.2023.05.001

Type III acromioclavicular dislocation: Mid term results after operative and non-operative treatment

Rev Esp Cir Ortop Traumatol. 2024 Jul-Aug;68(4):315-321. doi: 10.1016/j.recot.2023.05.001. Epub 2023 May 13.

[Article in English, Spanish]

Authors

L Álvarez-Álvarez¹, M Cela-López², E González-Rodríguez², A García-Perez², M Rodríguez-Arenas², M Castro-Menéndez²

Affiliations

¹ Departamento de Cirugía Ortopédica y Traumatología, Hospital Álvaro Cunqueiro, Vigo, España. Electronic address: lucia.alvarez.alvarez@sergas.es.
² Departamento de Cirugía Ortopédica y Traumatología, Hospital Álvaro Cunqueiro, Vigo, España.

PMID: 37187342
DOI: 10.1016/j.recot.2023.05.001

Abstract

Introduction: Controversy exists in the literature about the best treatment for type III acromioclavicular dislocations. The aim of this study is to compare functional results between surgical and conservative treatment in type III acromioclavicular joint dislocations.

Material and method: We retrospectively evaluated the records of 30 patients from our area with acute type III acromioclavicular dislocations that were treated from January 1st, 2016 to December 31st, 2020. Fifteen patients were treated surgically and 15 conservatively. Follow up mean time was 37.93 months in operative group and 35.73 months in non-operative group. Results obtained on the Constant score was the main variable analysed and results obtained on the Oxford score and the Visual Analogue Scale for pain were the secondary variables. Epidemiological variables were analysed, as well as range of mobility in injured shoulder and subjective and radiological variables (distance between the superior border of the acromion and the superior border of the clavicle's distal end and presence of osteoarthritis in the acromioclavicular joint).

Results: Functional evaluation scores did not show differences between the two groups (Constant: operative 82/non-operative 86.38, p 0.412; Oxford: operative 42/non-operative 44.80, p 0.126) nor did Visual Analogue Scale (operative 1/non-operative 0.20, p 0.345). Subjective evaluation of the injured shoulder was excellent or good in 80% of the patients in both groups. Measurement of the distance between the superior border of the acromion and the superior border of the clavicle's distal end were significantly higher in non-operative group (operative 8.95/non-operative 14.21, p 0.008).

Conclusions: Although radiographic results were better in the surgical treatment group, functional evaluation scores did not show significant differences between the two groups. These results do not support the routine use of surgical treatment for grade III acromioclavicular dislocations.

Keywords: Acromioclavicular dislocation; Functional result; Luxación acromioclavicular; Non-operative treatment; Operative treatment; Resultado funcional; Roockwood tipo III; Roockwood type III; Tratamiento conservador; Tratamiento quirúrgico.