title: Surgical treatment of Rockwood grade-V acromioclavicular joint dislocations: 50 patients followed for 15–22 years.
abstract: OBJECTIVE
  Long-term outcome after surgery for grade-V acromioclavicular joint dislocation has not been reported. We performed a retrospective analysis of functional and radiographic outcome 15-22 years after surgery.
  
  
  METHODS
  We examined 50 patients who were treated at our hospital between April 1985 and December 1993. Various methods of stabilization were used: K-wires (n = 36), 4.5-mm screw (n = 12), or biodegradable screw (n = 2). Osteosynthesis material was removed after 6-8 weeks. Mean follow-up time was 18 (15-22) years. Outcomes were assessed with the Constant shoulder (CS) score, Disabilities of the Arm, Shoulder, and Hand (DASH) score, the simple shoulder test (SST), the Copeland shoulder impingement test, the cross-arm test, pain, stability of the AC joint, and complications. From radiographs, we evaluated AC and glenohumeral (GH) arthrosis, osteolysis of the lateral clavicle, and alignment of the clavicle with the acromion.
  
  
  RESULTS
  Mean values were 90 (75-100) in CS score, 5.1 (0-41) in DASH score, and 11 (2-12) in SST. There was no statistically significant difference in CS score between the injured shoulder and the uninjured shoulder. The AC joint was clinically stable in 42 patients. In 38 patients, the clavicle alignment with the acromion was normal in radiographs. Lateral clavicle osteolysis (10 patients) appeared to be associated with permanent AC joint dislocation.
  
  
  CONCLUSIONS
  Surgery with a temporary fixation for acute grade-V AC joint dislocation leads to successful long-term functional results. Only minor disability occurred in some patients.
authors: Department of Orthopaedics and Traumatology, Helsinki University Central Hospital and University of Helsinki, Finland. kaisa.virtanen@hus.fi
authors: Kaisa J
authors: KJ
authors: Virtanen
authors: Ville M
authors: VM
authors: Remes
authors: Ilkka T A
authors: IT
authors: Tulikoura
authors: Jarkko T
authors: JT
authors: Pajarinen
authors: Vesa T
authors: VT
authors: Savolainen
authors: Jan-Magnus G
authors: JM
authors: Björkenheim
authors: Mika P
authors: MP
authors: Paavola
mesh_terms: D000173:Acromioclavicular Joint / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D000174:Acromion / Q000000981:diagnostic imaging; D000328:Adult; D000368:Aged; D001863:Bone Screws; D001864:Bone Wires; D002968:Clavicle / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D016268:Internal Fixators; D004204:Joint Dislocations / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011859:Radiography; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D012785:Shoulder Joint / Q000000981:diagnostic imaging; D016896:Treatment Outcome; D055815:Young Adult