title: Management of acute unstable acromioclavicular joint injuries.
abstract: Surgical management of acute unstable acromioclavicular joint injuries should be focused on realigning the torn ends of the ligaments to allow for healing potential. The most widely utilized treatment methods incorporate the use of metal hardware, which can alter the biomechanics of the acromioclavicular joint. This leads to a second surgical procedure for hardware removal once the ligaments have healed. Patients with unstable acromioclavicular joint injuries managed with arthroscopy-assisted procedures have shown good and excellent clinical outcomes, without the need for a second operation. These procedures incorporate a coracoclavicular suspension device aimed to function as an internal brace, narrowing the coracoclavicular space thus allowing for healing of the torn coracoclavicular ligaments. The lesser morbidity of a minimally invasive approach and the possibility to diagnose and treat concomitant intraarticular injuries; no obligatory implant removal, and the possibility of having a straight visualization of the inferior aspect of the base of the coracoid (convenient when placing coracoclavicular fixation systems) are the main advantages of the arthroscopic approach over classic open procedures. This article consists on a narrative review of the literature in regard to the management of acute acromioclavicular joint instability.
authors.affiliation: Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Street Sant Quintí 89, 08026, Barcelona, Catalunya, Spain. luisgerardonaterac@gmail.com.|Hospital General de Catalunya, Street Pedro i Pons 1, 08190, Sant Cugat del Vallés, Catalunya, Spain. luisgerardonaterac@gmail.com.
authors.forename: Luis Natera
authors.initials: LN
authors.lastname: Cisneros
authors.affiliation: Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Street Sant Quintí 89, 08026, Barcelona, Catalunya, Spain.|Hospital Quirón Teknon, Street Vilana 12, 08022, Barcelona, Catalunya, Spain.
authors.forename: Juan Sarasquete
authors.initials: JS
authors.lastname: Reiriz
mesh_terms: D000173:Acromioclavicular Joint / Q000293:injuries / Q000601:surgery; D001182:Arthroscopy / Q000009:adverse effects / Q000379:methods; D000072039:Fracture Dislocation / Q000601:surgery*; D005592:Fracture Fixation / Q000009:adverse effects / Q000379:methods; D006801:Humans; D009984:Orthopedic Fixation Devices; D012086:Reoperation / Q000379:methods; D016896:Treatment Outcome
keywords: Acute setting; Anatomic ligament reconstruction; Arthroscopically assisted management; Coracoclavicular suspension devices; Metal hardware; Unstable acromioclavicular joint injuries