Clinical Evaluation and Instrumental Diagnostics in Acute Acromioclavicular Joint Dislocation.

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Abstract

[Indexed for MEDLINE] 15. Unfallchirurg. 2015 May;118(5):407-14. doi: 10.1007/s00113-015-0004-0. [Arthroscopically assisted techniques for treatment of acute and chronic acromioclavicular joint injuries]. [Article in German] Braun S(1), Imhoff AB, Martetschläger F. Author information: (1)Abteilung und Poliklinik für Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, München, Deutschland, sepp.braun@lrz.tum.de. Acute and chronic acromioclavicular (AC) joint dislocation is frequently encountered in the routine clinical practice. This injury can lead to significant impairment of shoulder girdle function. Therapy based on the severity of injury is recommended to re-establish correct shoulder function. The static radiographic Rockwood classification is used to define the degree of dislocation but the clinical aspects and functional x-ray imaging of horizontal AC joint instability should also be considered for selection of the appropriate procedure. Rockwood grades I and II injuries are treated non-operatively with early functional exercise. The approach for Rockwood grade III injuries should be individual and patient-specific, with non-surgical procedures for low functional requirement patients with a high risk for surgical interventions. For patients with high demands on shoulder function surgery is recommended. A detailed diagnostic assessment frequently reveals Rockwood grade III injuries to be type IV injuries. Rockwood types IV and V AC joint dislocations require surgery for sustained stability. Treatment of acute injuries is recommended within 1-3 weeks after trauma but there is no clear evidence of a cut-off for the presence of chronic injuries. Various surgical techniques have been described in the literature. This article presents an arthroscopically assisted technique that addresses both vertical and horizontal instability of the AC joint. DOI: 10.1007/s00113-015-0004-0