Functional outcome of conservative treatment of acute type 3 Acromioclavicular joint dislocation

Abstract

Background and Objectives: Acromioclavicular joint dislocation corresponds to 8.6% of all joint dislocations. Non operative treatment is considered the standard of care for type I and II Acromioclavicular joint dislocation. But the treatment of acute type III and above injuries is still controversial. The purpose of this study is to determine the functional outcome of conservative treatment of Type III severity of acromioclavicular dislocations with respect to pain, range of movements, cosmesis and radiological displacement. Materials and Methods: 25 patients with Acromioclavicular joint dislocation of type 3 were included in our study conducted between August 2018 and July 2020. Stress X-Rays were taken to diagnose type 3 acromioclavicular joint dislocation. All patients were treated conservatively with strapping for three weeks and gradual mobilization over next three weeks. Patients were evaluated at 6 weeks, 3months and 6months. At each follow up patients were assessed subjectively for pain, objectively for range of abduction and radiographs were taken to note any displacement. Results: Sixteen patients had excellent results with no pain or limitation of movements. Six patients had good results with pain only on excessive activity and terminal restriction of movements. Two patients had fair results and no poor results. Improvement in subjective and objective symptoms was highly significant (p<0.01). But at final follow up all acromioclavicular joints were subluxed or dislocated. Conclusion: Conservative treatment of acute Type 3 Acromio clavicular joint dislocation with short periods of immobilization by bandages and slings and early rehabilitation of shoulder gives good short term results clinically although not correlated radiographically.