Abstract
Objectives The present study evaluates and compares the surgical treatment of acute and chronic
acromioclavicular dislocations (ACDs) to define the most effective therapeutic plan.
Methods A retrospective study consisting of 30 patients submitted to the surgical treatment
of types III and V ACDs between 2011 and 2018; the subjects were separated according
to a temporal classification in acute (< 3 weeks; subgroup I) and chronic (> 3 weeks;
subgroup II) subgroups. All patients underwent a postsurgical evaluation with a standardized
protocol containing epidemiological, functional, and radiological data.
Results Subgroup I presented a visual analog scale (VAS) score of 1.10, a Constant-Murley
score of 92.3, and a University of California at Los Angeles (UCLA) Shoulder Rating
score of 33.5. The coracoclavicular (CC) distance was of 11.0 mm, and the average
increase in CC space was lower than 8.9% compared to the contralateral shoulder. In
subgroup II, the VAS score was of 1.11, the Constant-Murley score was of 94.2, and
the UCLA score was of 32.4. The CC distance was of 13.8 mm, with a 22.9% increase
in CC space compared to the contralateral side.
Conclusion Although there was no significant difference between the evaluated items, subgroup
I tended to present a lower CC distance (p = 0.098) and a lower percentage increase in CC distance (p = 0.095) compared to subgroup II. Thus, the surgical treatment must be performed
within three weeks after the trauma to try to avoid such trend. If the acute treatment
is not possible, the modified Weaver Dunn technique has good clinical and functional
outcomes.
Keywords
acromioclavicular joint/injuries - acromioclavicular joint/surgery - joint dislocations
- ligaments, articular
