Skip to main content
Top
Published in: Current Reviews in Musculoskeletal Medicine 1/2014

01-03-2014 | Shoulder: Modern Techniques in Reconstruction (A Babhulkar, Section editor)

Acromioclavicular joint dislocations

Authors: Ashish Babhulkar, Aditya Pawaskar

Published in: Current Reviews in Musculoskeletal Medicine | Issue 1/2014

Login to get access

Abstract

Acromioclavicular (AC) dislocation is a common injury especially among sportsmen. There is still a lack of consensus on whether to conserve or operate type III AC joint dislocations. Even among surgeons inclined to operate AC joint dislocations there is no unanimity on which surgical technique. There are a plethora of choices between mechanical fixation or synthetic materials or biologic anatomic reconstructions. Even among surgeons, there is a choice between open repairs and the latest—arthroscopic reconstructions. This review of AC joint dislocations intends to analyze the available surgical options, a critical analysis of existing literature, actual technique of anatomic repair, and also accompanying complications.
Literature
1.
go back to reference Rockwood Jr CA, Young DC. Disorders of the acromioclavicular joint. In: Rockwood Jr CA, Matsen III FA, editors. The Shoulder, vol. 1. Philadelphia, PA: WB Saunders; 1990. p. 413–76. Rockwood Jr CA, Young DC. Disorders of the acromioclavicular joint. In: Rockwood Jr CA, Matsen III FA, editors. The Shoulder, vol. 1. Philadelphia, PA: WB Saunders; 1990. p. 413–76.
2.
go back to reference Allman Jr FL. Fractures and ligamentous injuries of the clavicle and its articulation. J Bone Joint Surg Am. 1967;49:774–84.PubMed Allman Jr FL. Fractures and ligamentous injuries of the clavicle and its articulation. J Bone Joint Surg Am. 1967;49:774–84.PubMed
3.
go back to reference Dias JJ, Gregg PJ. Acromioclavicular joint injuries in sport: recommendations for treatment. Sports Med. 1991;11:125–32.PubMedCrossRef Dias JJ, Gregg PJ. Acromioclavicular joint injuries in sport: recommendations for treatment. Sports Med. 1991;11:125–32.PubMedCrossRef
4.
go back to reference Lemos MJ. The evaluation and treatment of the injured acromioclavicular joint in athletes. Am J Sports Med. 1998;1:137–44. Lemos MJ. The evaluation and treatment of the injured acromioclavicular joint in athletes. Am J Sports Med. 1998;1:137–44.
5.
go back to reference Tossy JD, Mead NC, Sigmond HM. Acromioclavicular separations: useful and practical classification for treatment. Clin Orthop. 1963;28:111–9.PubMed Tossy JD, Mead NC, Sigmond HM. Acromioclavicular separations: useful and practical classification for treatment. Clin Orthop. 1963;28:111–9.PubMed
6.
go back to reference Rockwood Jr CA. Injuries to the acromioclavicular joint. In: Rockwood Jr CA, Green DP, editors. Fractures in Adults. Volume 1. 2nd ed. Philadelphia: JB Lippincott; 1984. p. 860–910. 974–82. Rockwood Jr CA. Injuries to the acromioclavicular joint. In: Rockwood Jr CA, Green DP, editors. Fractures in Adults. Volume 1. 2nd ed. Philadelphia: JB Lippincott; 1984. p. 860–910. 974–82.
7.
go back to reference Mazzocca AD, Arciero RA, Bicos J. Evaluation and treatment of acromioclavicular joint injuries. Am J Sports Med. 2007;35:316–29.PubMedCrossRef Mazzocca AD, Arciero RA, Bicos J. Evaluation and treatment of acromioclavicular joint injuries. Am J Sports Med. 2007;35:316–29.PubMedCrossRef
8.
go back to reference Scapinelli R. Bipolar dislocation of the clavicle: 3D CT imaging and delayed surgical correction of a case. Arch Orthop Trauma Surg. 2004;124:421–4.PubMedCrossRef Scapinelli R. Bipolar dislocation of the clavicle: 3D CT imaging and delayed surgical correction of a case. Arch Orthop Trauma Surg. 2004;124:421–4.PubMedCrossRef
9.
go back to reference Echo BS, Donati RB, Powell CE. Bipolar clavicular dislocation treated surgically. A case report. J Bone Joint Surg Am. 1988;70:1251–3.PubMed Echo BS, Donati RB, Powell CE. Bipolar clavicular dislocation treated surgically. A case report. J Bone Joint Surg Am. 1988;70:1251–3.PubMed
10.
go back to reference Simovitch R, Sanders B, Ozbaydar M, et al. Acromioclavicular joint injuries: diagnosis and management. J Am Acad Orthop Surg. 2009;17:207–19.PubMed Simovitch R, Sanders B, Ozbaydar M, et al. Acromioclavicular joint injuries: diagnosis and management. J Am Acad Orthop Surg. 2009;17:207–19.PubMed
11.••
go back to reference Pauly S, Kraus N, Greiner S, et al. Prevalence and pattern of glenohumeral injuries among acute high-grade acromioclavicular joint instabilities. J Shoulder Elbow Surg. 2013;22:760–6. Emphasizes the association of Gleno-humeral lesions in association with AC joint dislocations, recommending at least a diagnostic shoulder scopy in AC joint patients.PubMedCrossRef Pauly S, Kraus N, Greiner S, et al. Prevalence and pattern of glenohumeral injuries among acute high-grade acromioclavicular joint instabilities. J Shoulder Elbow Surg. 2013;22:760–6. Emphasizes the association of Gleno-humeral lesions in association with AC joint dislocations, recommending at least a diagnostic shoulder scopy in AC joint patients.PubMedCrossRef
12.
go back to reference Matani RJ, Hanlon JJ, Cady GW. Acute, complete acromioclavicular separation. J Bone Joint Surg Am. 1975;57:328–32. Matani RJ, Hanlon JJ, Cady GW. Acute, complete acromioclavicular separation. J Bone Joint Surg Am. 1975;57:328–32.
13.
go back to reference Bearden JM, Hughston JC, Whatley GS. Acromioclavicular dislocation: method of treatment. Am J Sports Med. 1973;1:5–17.CrossRef Bearden JM, Hughston JC, Whatley GS. Acromioclavicular dislocation: method of treatment. Am J Sports Med. 1973;1:5–17.CrossRef
14.
go back to reference Sim E, Schwarz N, Hocker K, et al. Repair of complete acromioclavicular separations using the acromioclavicular-hook plate. Clin Orthop Relat Res. 1995;314:134–42.PubMed Sim E, Schwarz N, Hocker K, et al. Repair of complete acromioclavicular separations using the acromioclavicular-hook plate. Clin Orthop Relat Res. 1995;314:134–42.PubMed
15.
go back to reference Jari R, Costic RS, Rodosky MW, et al. Biomechanical function of surgical procedures for acromioclavicular joint dislocations. Arthroscopy. 2004;20:237–45.PubMedCrossRef Jari R, Costic RS, Rodosky MW, et al. Biomechanical function of surgical procedures for acromioclavicular joint dislocations. Arthroscopy. 2004;20:237–45.PubMedCrossRef
16.
go back to reference Baker JE, Nicandri GT, Young DC, et al. A cadaveric study examining acromioclavicular joint congruity after different methods of coracoclavicular loop repair. J Shoulder Elbow Surg. 2003;12:595–8.PubMedCrossRef Baker JE, Nicandri GT, Young DC, et al. A cadaveric study examining acromioclavicular joint congruity after different methods of coracoclavicular loop repair. J Shoulder Elbow Surg. 2003;12:595–8.PubMedCrossRef
17.
go back to reference Breslow MJ, Jazrawi LM, Bernstein AD, et al. Treatment of acromioclavicular joint separation: suture or suture anchors? J Shoulder Elbow Surg. 2002. Breslow MJ, Jazrawi LM, Bernstein AD, et al. Treatment of acromioclavicular joint separation: suture or suture anchors? J Shoulder Elbow Surg. 2002.
18.
go back to reference Calvo E, Lopez-Franco M, Arribas IM. Clinical and radiologic outcomes of surgical and conservative treatment of type III acromioclavicular joint injury. J Shoulder Elbow Surg. 2006. Calvo E, Lopez-Franco M, Arribas IM. Clinical and radiologic outcomes of surgical and conservative treatment of type III acromioclavicular joint injury. J Shoulder Elbow Surg. 2006.
19.
go back to reference Wellmann M, Zantop T, Petersen W. Minimally invasive coracoclavicular ligament augmentation with a flip button/polydioxanone repair for treatment of total acromioclavicular joint dislocation. Arthroscopy. 2007;23. Wellmann M, Zantop T, Petersen W. Minimally invasive coracoclavicular ligament augmentation with a flip button/polydioxanone repair for treatment of total acromioclavicular joint dislocation. Arthroscopy. 2007;23.
20.
go back to reference Thiel E, Mutnal A, Gilot GJ. Surgical outcome following arthroscopic fixation of acromioclavicular joint disruption with the tightrope device. Orthopedics. 2011;34. Thiel E, Mutnal A, Gilot GJ. Surgical outcome following arthroscopic fixation of acromioclavicular joint disruption with the tightrope device. Orthopedics. 2011;34.
21.••
go back to reference Mazzocca AD, Santangelo SA, Johnson ST, et al. A biomechanical evaluation of an anatomical coracoclavicular ligament reconstruction. Am J Sports Med. 2006;34:236–46. Gives precise anatomy of CC ligaments and hence, recommendations on placing the clavicular tunnels.PubMedCrossRef Mazzocca AD, Santangelo SA, Johnson ST, et al. A biomechanical evaluation of an anatomical coracoclavicular ligament reconstruction. Am J Sports Med. 2006;34:236–46. Gives precise anatomy of CC ligaments and hence, recommendations on placing the clavicular tunnels.PubMedCrossRef
22.
go back to reference Farber AJ, Cascio BM, Wilckens JH. Type III acromioclavicular separation: rationale for anatomical reconstruction. Am J Orthop. 2008;37:349–55.PubMed Farber AJ, Cascio BM, Wilckens JH. Type III acromioclavicular separation: rationale for anatomical reconstruction. Am J Orthop. 2008;37:349–55.PubMed
23.
go back to reference Lee SJ, Nicholas SJ, Akizuki KH, et al. Reconstruction of the coracoclavicular ligaments with tendon grafts: a comparative biomechanical study. Am J Sports Med. 2003;31:648–54.PubMed Lee SJ, Nicholas SJ, Akizuki KH, et al. Reconstruction of the coracoclavicular ligaments with tendon grafts: a comparative biomechanical study. Am J Sports Med. 2003;31:648–54.PubMed
24.
go back to reference Sani Erak MH, Pelletier MH, Woods KR, et al. Acromioclavicular reconstructions with hamstring tendon grafts: a comparative biomechanical study. J Shoulder Elbow Surg. 2008;17:772–8.PubMedCrossRef Sani Erak MH, Pelletier MH, Woods KR, et al. Acromioclavicular reconstructions with hamstring tendon grafts: a comparative biomechanical study. J Shoulder Elbow Surg. 2008;17:772–8.PubMedCrossRef
25.
go back to reference Tauber M, Gordon K, Koller H, et al. Semitendinosus tendon graft versus a modified Weaver-Dunn procedure for acromioclavicular joint reconstruction in chronic cases: a prospective comparative study. Am J Sports Med. 2009;37:181–90.PubMedCrossRef Tauber M, Gordon K, Koller H, et al. Semitendinosus tendon graft versus a modified Weaver-Dunn procedure for acromioclavicular joint reconstruction in chronic cases: a prospective comparative study. Am J Sports Med. 2009;37:181–90.PubMedCrossRef
26.••
go back to reference Carofino BC, Mazzocca AD. The anatomic coracoclavicular ligament reconstruction: surgical technique and indications. J Shoulder Elbow Surg. 2010;19:37–46. Denotes the surgical detail and nuances of technique.PubMedCrossRef Carofino BC, Mazzocca AD. The anatomic coracoclavicular ligament reconstruction: surgical technique and indications. J Shoulder Elbow Surg. 2010;19:37–46. Denotes the surgical detail and nuances of technique.PubMedCrossRef
27.
go back to reference Mazzoca et al. Injuries to the acromioclavicular joint in children. In: Delee JC, Drez D, editors. Orthopedic Sports Medicine. 2nd ed. Philadelphia: Saunders; 2003. 2003. p. Mazzoca et al. Injuries to the acromioclavicular joint in children. In: Delee JC, Drez D, editors. Orthopedic Sports Medicine. 2nd ed. Philadelphia: Saunders; 2003. 2003. p.
28.
29.
go back to reference Stam L, Dawson I. Complete acromioclavicular dislocations. Treatment with Dacron ligament. Injury. 1991;173–6. Stam L, Dawson I. Complete acromioclavicular dislocations. Treatment with Dacron ligament. Injury. 1991;173–6.
30.
go back to reference Larsen E, Bjerg-Nielson A, Christensen P. Conservative treatment of acromioclavicular dislocation. A prospective controlled randomized study. J Bone Joint Surg. 1986;68A:552–5. Larsen E, Bjerg-Nielson A, Christensen P. Conservative treatment of acromioclavicular dislocation. A prospective controlled randomized study. J Bone Joint Surg. 1986;68A:552–5.
31.
go back to reference Neault MA, Nuber GW, Marymont JV. Infections after surgical repair of acromioclavicular separations with nonabsorbable tape or suture. J Shoulder Elbow Surg. 1996;5:477–8.PubMedCrossRef Neault MA, Nuber GW, Marymont JV. Infections after surgical repair of acromioclavicular separations with nonabsorbable tape or suture. J Shoulder Elbow Surg. 1996;5:477–8.PubMedCrossRef
32.
go back to reference Mazet RJ. Migration of a Kirschner wire from the shoulder region into the lung: report of 2 cases. J Bone Joint Surg. 1943;25A:477–83. Mazet RJ. Migration of a Kirschner wire from the shoulder region into the lung: report of 2 cases. J Bone Joint Surg. 1943;25A:477–83.
33.
go back to reference Norrell H, Lyewellyn RC. Migration of a threaded Steinmann pin from an acromioclavicular joint into the spinal canal: a case report. J Bone Joint Surg. 1965;47:1024–6.PubMed Norrell H, Lyewellyn RC. Migration of a threaded Steinmann pin from an acromioclavicular joint into the spinal canal: a case report. J Bone Joint Surg. 1965;47:1024–6.PubMed
34.
go back to reference Eaton R, Serletti J. Computerized axial tomography— a method of localizing Steinmann pin migration: a case report. Orthopaedics. 1981;4:1357–60. Eaton R, Serletti J. Computerized axial tomography— a method of localizing Steinmann pin migration: a case report. Orthopaedics. 1981;4:1357–60.
35.
go back to reference Kappakas GS, McMaster JH. Repair of acromioclavicular separation using a Dacron prosthesis graft. Clin Orthop. 1978;131:247–51.PubMed Kappakas GS, McMaster JH. Repair of acromioclavicular separation using a Dacron prosthesis graft. Clin Orthop. 1978;131:247–51.PubMed
36.
go back to reference Nelson CL. Repair of acromioclavicular separations with knitted Dacron graft. Clin Orthop. 1979;143:289. Nelson CL. Repair of acromioclavicular separations with knitted Dacron graft. Clin Orthop. 1979;143:289.
37.
go back to reference Park JP, Arnold JA, Coker TP. Treatment of acromioclavicular separations: a retrospective study. Am J Sports Med. 1980;8:251–6.PubMedCrossRef Park JP, Arnold JA, Coker TP. Treatment of acromioclavicular separations: a retrospective study. Am J Sports Med. 1980;8:251–6.PubMedCrossRef
38.•
go back to reference Bindra J, VanDenBogaerde J, Hunter JC. Coracoid fracture with recurrent AC joint separation after tightrope repair of AC joint dislocation. Radiology Case Reports. 2011;6:624. Report of real risks on coracoid fracture and similar failure in association with nonbiologic reconstruction techniques. Bindra J, VanDenBogaerde J, Hunter JC. Coracoid fracture with recurrent AC joint separation after tightrope repair of AC joint dislocation. Radiology Case Reports. 2011;6:624. Report of real risks on coracoid fracture and similar failure in association with nonbiologic reconstruction techniques.
39.
go back to reference Meislin RJ, Zuckerman JD, Nainzadeh N. Type III acromioclavicular joint separation associated with late brachial plexus neuropraxia. J Orth Trauma. 1992;6:370–2.CrossRef Meislin RJ, Zuckerman JD, Nainzadeh N. Type III acromioclavicular joint separation associated with late brachial plexus neuropraxia. J Orth Trauma. 1992;6:370–2.CrossRef
40.
go back to reference Debski E, Parsons IM, Woo SL-Y, et al. Effect of capsular injury on acromioclavicular joint mechanics. J Bone Joint Surg Am. 2001;83:1344–51.PubMed Debski E, Parsons IM, Woo SL-Y, et al. Effect of capsular injury on acromioclavicular joint mechanics. J Bone Joint Surg Am. 2001;83:1344–51.PubMed
Metadata
Title
Acromioclavicular joint dislocations
Authors
Ashish Babhulkar
Aditya Pawaskar
Publication date
01-03-2014
Publisher
Springer US
Published in
Current Reviews in Musculoskeletal Medicine / Issue 1/2014
Electronic ISSN: 1935-9748
DOI
https://doi.org/10.1007/s12178-013-9199-2

Other articles of this Issue 1/2014

Current Reviews in Musculoskeletal Medicine 1/2014 Go to the issue

Hand and Wrist: Plastics (DT Fufa, Section editor)

Embryology, diagnosis, and evaluation of congenital hand anomalies

Hand and Wrist: Plastics (DT Fufa, Section editor)

Hand reanimation

Hand and Wrist: Plastics (DT Fufa, Section editor)

Prevention and Surgical Management of Postburn Contractures of the Hand

Hand and Wrist: Plastics (DT Fufa, Section editor)

Nonmicrosurgical options for soft tissue reconstruction of the hand