Acromioclavicular dislocation Rockwood III-V: results of early versus delayed surgical treatment.
BACKGROUND
The management of acute acromioclavicular joint (ACJ-) injuries especially of type III is still controversial.


METHODS
In this retrospective study the results of early ACJ reconstructions immediately after trauma (group early repair, ER) were compared with the results of delayed reconstructions in patients who first got conservative treatment and failed after some time (group delayed repair, DR). Overall, 49 patients were analysed clinically and radiographically with a mean follow-up of 53 months (range 20-92). In group ER twenty-nine patients were treated with a modified Phemister technique according to Mayr including a PDS coracoclavicular sling and temporary K- wire fixation. In group DR twenty patients were treated with a modified Weaver-Dunn-procedure with additionally transposition of the coracoacromial ligament and AC-joint resection.


RESULTS
A comparison of the overall results revealed a statistically significant better outcome in the early repair group, regarding the Constant Score, the degree of acromioclavicularjoint-reduction, numbers of complications and patient;s satisfaction.


CONCLUSIONS
Our results point out that early reconstruction of ACJ-injuries in type III-V avoids the inferior clinical results of delayed reconstructions using a modified Weaver-Dunn-procedure.
Department of Orthopaedic Surgery, König-Ludwig Haus Würzburg, Würzburg, Germany. o-rolf.klh@uni-wuerzburg.de
Olaf
O
Rolf
Andreas
A
Hann von Weyhern
Alexander
A
Ewers
Thomas Dirk
TD
Boehm
Frank
F
Gohlke
D000173:Acromioclavicular Joint / Q000293:injuries* / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult