Acromioclavicular dislocation Rockwood III-V: results of early versus delayed surgical treatment.

INTRODUCTION: 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.

CONCLUSION: 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.