A. Eskola et al., THE RESULTS OF OPERATIVE RESECTION OF THE LATERAL END OF THE CLAVICLE, Journal of bone and joint surgery. American volume, 78A(4), 1996, pp. 584-587
Seventy-three patients had operative resection of the lateral end of t
he clavicle for the treatment of a painful condition of the acromiocla
vicular joint. Thirty-two of the patients had had a traumatic separati
on of the acromioclavicular joint, eight had had a fracture of the lat
eral end of the clavicle, and thirty-three had primary acromioclavicul
ar osteoarthrosis. An average of sixteen millimeters (range, five to t
hirty-seven millimeters) was resected; the amount was similar in each
of the three groups. The patients were evaluated an average of nine ye
ars (range, four to sixteen years) after the operation. The result was
considered good in twenty-one patients, satisfactory in twenty-nine,
and poor in twenty-three. A poor result was more common in the patient
s who had had a fracture of the lateral end of the clavicle (p < 0.01)
, Forty-six patients reported pain with exertion, and thirteen noted p
ain at rest. Eighteen patients had a decrease in the strength of the i
nvolved upper extremity and sixteen had some limitation of the mobilit
y of the shoulder. Elevation of the lateral end of the remaining part
of the clavicle as compared with the scapula was noted in eighteen pat
ients and was more likely to be associated with pain (p < 0.05). The e
xtent of the resection was significantly associated with pain; patient
s who had had a smaller amount of resection (ten millimeters or less)
had less pain than those who had had a larger amount (p < 0.03). A goo
d result was more common in the patients in whom less than ten millime
ters had been resected and who had had a previous traumatic separation
of the acromioclavicular joint or had primary acromioclavicular osteo
arthrosis. We recommend that resection of the lateral end of the clavi
cle be considered with caution for patients who have severe post-traum
atic or degenerative osteoarthrosis of the acromioclavicular joint. If
resection is performed, it should not exceed ten millimeters.