[Acute acromioclavicular joint dislocation--operative or conservative therapy?].
42 patients with complete acromioclavicular dislocation treated operatively and 38 patients managed non-operatively were examined retrospectively with a mean follow-up of 6.3 +/- 2.5 years. The dislocations in both groups included type III and type V injuries according to the Rockwood-classification. The operative technique was suturing of the tom ligaments and stabilization of the acromioclavicular joint using resorbable coracoclavicular PDS-banding. In non-operative treatment, early physiotherapy accepting the deformity was performed in most of the patients. The clinical results using the UCLA- and the Constant-Murley score as well as evaluation of pain, function and strength were similar in both groups. Those patients suffering from a more severe dislocation type Rockwood V who were treated non-operatively had as good results as those patients with grade III dislocation. Posttraumatic osteoarthritis developed mainly in those patients whose acromioclavicular joint healed in partial dislocation. Non-operative treatment was equal even in less severe dislocations in the subgroup of type Rockwood V injuries. The persisting deformity which must be expected in non-operative treatment did not affect the patient's outcome regarding pain, function and strength of the shoulder.
Fremerey
R W
RW
Unfallchirurgische Klinik, Medizinische Hochschule Hannover, Carl-Neuberg-Strasse 1, 30625 Hannover. ReinhardFremerey@t-online.de
Lobenhoffer
P
P
Ramacker
K
K
Gerich
T
T
Skutek
M
M
Bosch
U
U
D000173:Acromioclavicular Joint / Q000293:injuries* / Q000503:physiopathology / Q000601:surgery; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007537:Isometric Contraction / Q000502:physiology; D004204:Joint Dislocations / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology