Acromioclavicular-Joint Injury

AN END-RESULT STUDY

¹ From the Combined Fracture Service of The New York Hospital and The Hospital for Special Surgery-Cornell Medical Center, New York

From 1933 to 1959 sixty-two partial separations and fifty-four complete separations or dislocations of the acromioclavicular joint in 116 patients were treated on the Combined Fracture Service of The New York Hospital and The Hospital for Special Surgery. Fifty patients were treated non-operatively and sixty-six, surgically. Ninety-four of the 116 patients returned for follow-up evaluation from five to thirty-five years after treatment.

Forty-three of fifty patients treated non-operatively were evaluated. At follow-up twenty-one were asymptomatic, thirty-four had normal shoulder motion, and only four had no residual deformity of the acromioclavicular joint.

Twenty-nine of the thirty-five patients treated by open reduction and ligament repair were re-examined. At follow-up fourteen were asymptomatic, twenty had normal shoulder abduction, and fifteen had no residual deformity.

Of the six patients treated by coracoclavicular screw fixation, two were asymptomatic, two had normal shoulder abduction, and four had no residual deformity at follow-up.

Sixteen of the twenty patients treated by partial claviculectomy were reexamined. Seven were asymptomatic, thirteen had normal motion, and ten had no residual deformity at follow-up.

Of the patients re-examined, only twelve were dissatisfied because of residual pain. Of these, six had been treated by open reduction and ligament repair, one by a coracoclavicular screw, and five non-operatively.

For complete dislocations the results were quite similar with respect to residual pain and function, regardless of the type of treatment or the degree of residual separation. The causes of symptoms are analyzed and recommendations for treatment are presented.

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