title: Comparison of the outcome of early and delayed surgical treatment of complete acromioclavicular joint dislocation.
abstract: OBJECTIVE
  The aim of this study is to compare the clinical and radiographic results and the complication rate between early and delayed surgical treatment of acromioclavicular joint (ACJ) dislocation.
  
  
  METHODS
  Publications in the management of ACJ dislocation are identified from the PubMed database between January 1993 and December 2013 using "acromioclavicular joint" and "dislocation" as keywords. The eligibility criteria included are as follows: (1) ACJ dislocation; (2) intervention, early compared with delayed surgical treatment or the surgical treatment for acute compared with chronic ACJ dislocation; (3) human; and (4) English articles. Exclusion criteria consist of the following: (1) type I and type II ACJ dislocation, (2) no definition of the time of early and delayed surgery in studies, (3) no comparison between the clinical result of early and delayed surgery in studies, (4) laboratory studies, radiographic studies, biomechanical studies, (5) the cases including fractures or revisions in studies, and (6) systematic analyses.
  
  
  RESULTS
  Eight studies comparing early and delayed surgical treatment of ACJ dislocation are included in this systematic review. According to Constant scores and shoulder subjective value, early surgery has better functional outcomes than delayed surgery in the treatment of ACJ dislocation (P < 0.05). Partial-dislocation/re-dislocation is found at 26.0 % in early and 38.1 % in delayed surgical treatment (P < 0.05). The rate of CC ossification in early surgical treatment is found as the same as the delayed. The complication rates are found at 12.5 % in early surgical treatment and 17.7 % in the delayed, which is not significantly different.
  
  
  CONCLUSIONS
  Early surgical treatment may have superiority to the delayed procedure in the management of ACJ dislocation with better functional outcomes and more satisfied reduction. However, high-quality evidence studies are required to provide stronger support for this opinion in the future.
  
  
  METHODS
  IV.
authors.affiliation: Department of Orthopaedic Surgery, Shanghai Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China.
authors.forename: Tengfei
authors.initials: T
authors.lastname: Song
authors.affiliation: Department of Orthopaedic surgery, 455 Hospital of PLA, 338 West Huaihai Road, Shanghai, 200052, China.
authors.forename: Xu
authors.initials: X
authors.lastname: Yan
authors.affiliation: Department of Orthopaedic Surgery, Shanghai Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China. yetianwen@hotmail.com.
authors.forename: Tianwen
authors.initials: T
authors.lastname: Ye
mesh_terms: D000173:Acromioclavicular Joint / Q000601:surgery*; D006801:Humans; D009999:Ossification, Heterotopic; D012008:Recurrence; D012783:Shoulder Dislocation / Q000601:surgery*; D061665:Time-to-Treatment
keywords: Acromioclavicular joint; Dislocation; Surgical intervention; Treatment time