Acromioclavicular joint dislocations

Abstract

Acromioclavicular (AC) dislocation is a common injury especially among sportsmen. There is still a lack of consensus on whether to conserve or operate type III AC joint dislocations. Even among surgeons inclined to operate AC joint dislocations there is no unanimity on which surgical technique. There are a plethora of choices between mechanical fixation or synthetic materials or biologic anatomic reconstructions. Even among surgeons, there is a choice between open repairs and the latest-arthroscopic reconstructions. This review of AC joint dislocations intends to analyze the available surgical options, a critical analysis of existing literature, actual technique of anatomic repair, and also accompanying complications.

Operative treatment of acute acromioclavicular dislocations Rockwood III and V—Comparative study between K-wires combined with FiberTape® vs. TightRope System®

“…There are many different fixation techniques that use a variety of materials, such as heavy suture or surgical tape, autograft or allograft that can be fixated with sutures, suture anchors, suture buttons and screws [1]. Disadvantages of fixation methods are suture cut-out, aseptic foreign-body reaction and osteolysis of the clavicle [1].…”

“…Disadvantages of fixation methods are suture cut-out, aseptic foreign-body reaction and osteolysis of the clavicle [1].…”

“…ligaments, AC anterior and superior, which are the main structures responsible for horizontal stability and coracoclavicular ligaments (conoid and trapezoid ligament) are responsible for vertical stability of the joint [1]. Dislocations of the AC joint usually occur in a young active population [2].…”

“…Optimal treatment of AC dislocations is still a matter of discussion [1]; however, some kind of consensus has been reached regarding low-and high-energy trauma [6]. Low-energy trauma, which is classified as types I and II, is treated conservatively by using either a harness or a sling [6,7].…”

Clinical and Radiologic Outcomes of Acute Acromioclavicular Joint Dislocation: Comparison of Kirschner's Wire Transfixation and Locking Hook Plate Fixation

“…It is widely accepted that Rockwood types I and II ACJ dislocations can be treated conservatively and types IV to VI ACJ dislocations require surgical treatment. 27) But ideal management of type III injuries is still controversial. 7,16) Recently, many authors recommend surgical reconstruction exclusively for young patients, in athletes or for heavy workers.…”