Conservative management of a type III acromioclavicular separation: a case report and 10-year follow-up

Abstract

The patient yielded excellent results from conservative chiropractic management that was reflected in a prompt return to work 19 days after the injury. Follow-up at 1, 3, 5, 7, and 10 years exhibited absence of residual deficits in ROM and function. The "step deformity" was still present after the injury on the right.

Can an acute high-grade acromioclavicular joint separation be reduced and stabilized without surgery? A surgeon’s experience

“…Until today there are no reports of devices that achieve clavicle depression and humeral elevation to realign the AC joint after high-grade AC joint separations. Cloth slings or shoulder immobilizers protect the shoulder from rotation and give support against gravity [ 15 ] yet they do not provide any form of active joint reduction.…”

“…The literature describes various conservative methods to treat AC joint separations, ranging from the original spica cast method described by Tossy et al in 1963 [11] to the nowadays more common shoulder immobilization in a cloth sling [12][13][14] and isolated attempts to achieve clavicle depression with Leukotape [15]. Most experts combine shoulder immobilization for a few days with physiotherapy, yet no consensus exists regarding conservative treatment algorithms and immobilization devices for the post-injury phase.…”

Chiropractic Treatment of Lateral Epicondylitis: A Case Report Utilizing Active Release Techniques

“…[18][19][20] Currently there is a limited, but growing, amount of literature indicating positive outcomes following the application of ART in certain musculoskeletal conditions, including 1 case involving lateral epicondylitis. 18,[36][37][38][39][40][41][42][43][44][45][46][47][48] ART is described as a hands-on touch and case-management system that allows a practitioner to diagnose and treat soft-tissue injuries. 49 ART is founded on the principle of recognizing and treating cumulative injury disorder (CID).…”

“…It is interesting to note that other case reports indicating positive outcomes following ART interventions have been reported; however most consist of a multi-modal treatment approach. 18,[36][37][38][39][40][41][42][43][44][45][46][47][48] Lateral epicondylitis is a common musculoskeletal injury that is largely seen as a result of soft tissue overuse that leads to angiofibroblastic and collagen degeneration. Currently, there is a wide array of treatment options, though evidence to suggest the effective use of a singular treatment is lacking.…”

Conservative treatment of Rockwood type III acromioclavicular joint separation: a randomized controlled trial sling vs. brace

“…These include the traditional spica cast, 30 bracing, 31 , 36 and taping. 20 While casting and braces of the “Kenny Howard” type are restrictive and bulky, taping can lead to skin reactions and therefore reduce patient compliance. 3 Furthermore, there is no guarantee that the acromioclavicular joint (ACJ) will remain reduced.…”