Surgical Management of Acromioclavicular Joint Injuries

Abstract

 Acromioclavicular joint forms the connection between clavicle and the acromion of the scapula.  Injuries to acromioclavicular joint forms about 12 % of all shoulder injuries.  There are two etiologies of injury, the first by direct blow to the lateral aspect of the shoulder with arm adducted,and the second by indirect force by falling on an outstretched hand.  Clinical presentation varies and is frequently associated with pain over the superior part of the shoulder, restricted shoulder motion and prominence of clavicle in severe patterns of injury.  Diagnosis of ac joint injuries depends on clinical presentation, physical examination and imaging studies.  Treatment of ac joint injuries is conservative for type one and two injuries and surgical for type 4,5 and 6.  Injury type 3 management is controversial as most studies suggest that conservative treatment produces better outcomes than surgical.  Studies suggested surgical management of type 3 gives better results especially for heavy manual laborers.  Surgical treatment may be open surgical or arthroscopic.  Many surgical and arthroscopic techniques have been described and none of which has been proved superior to the other.