Grade 3 AC joint injury: A survey of current practice in the United Kingdom

Abstract

Acromio-clavicular (AC) joint injuries are a common injury seen in athletes and represent 9% to 12% of all shoulder injuries. There is no clear consensus on treatment of grade 3 injuries. We conducted a survey among upper limb surgeons in the United Kingdom to review commonly accepted practise. We found that majority of surgeons never did stress view. Most surgeons favoured surgery only if needed but not first choice. There is no consensus on timing of surgery. There are many fixation options available for AC joint dislocation and we found that surgeon's preferences were quiet wide for choosing fixation method. That is also evident from this questionnaire as there is no consensus in orthopaedic surgeons for ideal treatment of type 3 AC joint dislocations. Authors recommend randomized controlled trial to formulate definite treatment plan.

Current Concepts in Management of Acromioclavicular Joint Injury

“…A systematic review examining type III injuries found equivalent clinical outcomes of patients managed operatively and nonoperatively, with a quicker return to work and sport for the nonoperative group [ 48 ]. Surveys have found that most surgeons manage type III injuries nonoperatively in the Netherlands [ 49 ], United Kingdom [ 50 ], and the United States [ 51 , 52 ].…”

Évaluation biomécanique d’une nouvelle technique de stabilisation acromio-claviculaire par réparation directe

“…During the last decades numerous techniques to repair an acromioclavicular (AC) dislocation have been suggested [1][2][3][4][5][6]. Hereby the pendulum has swung from temporary transfixaton of the AC joint with K-wires or hook plates towards complex (extra-)anatomical soft tissue repair of the coracoclavicular (CC) ligaments [1,4,5]. These latest techniques demonstrated a restoration of the supero-inferior instability but did not provide adequate antero-posterior stability.…”

The “Chiang Mai Lean Forward” Radiographic View for Acromioclavicular Joint Injuries: A Cadaveric Study

“…16 Decision-making for the treatment of type 3 AC joint injuries is the most highly controversial. 11 The International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) Upper Extremity Committee subdivides type 3 injuries into subtypes 3A (stable) and 3B (unstable). 6 Its recommendation is that 3 weeks after an injury, a patient with a type 3 injury should undergo radiography in a special view, that is, the Alexander view 1 or the Basamania view, 4 to identify an unstable condition.…”