title: Operative or conservative treatment in patients with Rockwood type III acromioclavicular dislocation: a systematic review and update of current literature.
abstract: OBJECTIVE
  Despite previous studies the management of Rockwood type III acromioclavicular (AC) dislocations remains controversial and the debate continues about whether patients with Rockwood type III AC injuries should be treated conservatively or operatively. In this study, we will review the current literature and present an overview of the outcome of conservative versus operative treatment of Rockwood type III dislocations.
  
  
  METHODS
  The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was used to conduct this review. A systematic search was performed in the Pubmed, Cochrane library, Embase, Scopus and Cumulative Index to Nursing and Allied Health Literature databases. Titles and abstracts were screened using predefined criteria and articles were critically appraised on relevance and validity.
  
  
  RESULTS
  After critical appraisal eight articles were included in the study. The objective and subjective shoulder function outcome was better in the operative group, especially in young adults, though the rate of complications and radiographic abnormalities were higher. The rehabilitation time was shorter in the conservative group, however the cosmetic outcome was worse.
  
  
  CONCLUSIONS
  This review showed no conclusive evidence for the treatment of Rockwood type III AC dislocations. Overall, physically active young adults seem to have a slight advantage in outcome when treated operatively.
authors.affiliation: Department of Surgery, University Medical Center Utrecht, Suite G04.228, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands, k.korsten@umcutrecht.nl.
authors.forename: Koos
authors.initials: K
authors.lastname: Korsten
authors.forename: Amy C
authors.initials: AC
authors.lastname: Gunning
authors.forename: Luke P H
authors.initials: LP
authors.lastname: Leenen
mesh_terms: D000173:Acromioclavicular Joint / Q000293:injuries*; D006801:Humans; D004204:Joint Dislocations / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D012782:Shoulder / Q000503:physiopathology; D016896:Treatment Outcome