Gc. Bannister et al., A CLASSIFICATION OF ACUTE ACROMIOCLAVICULAR DISLOCATION - A CLINICAL,RADIOLOGICAL AND ANATOMICAL STUDY, Injury, 23(3), 1992, pp. 194-196
Forty-eight patients with acute acromioclavicular dislocation were ass
essed clinically and radiologically before random allocation to non-op
erative management (28) or open reduction and coracoclavicular screw f
ixation (20) and followed for a minimum of 4 years. In 6 patients, lat
e salvage surgery was required, the results of which were inferior to
early operative intervention. Early surgery also gave better results t
han non-operative treatment in severe disruptions which could be ident
ified in the acute stage. Three types of acromioclavicular dislocation
which have predictable clinical outcomes could be distinguished on ra
diographs. When treated non-operatively, type A dislocations (19 per c
ent) may develop painful subluxation, type B (68 per cent) remain disl
ocated but retain sufficient muscle attachment to avoid fatigue on act
ivity, and type C (per cent) leave a weak and unsightly shoulder. In t
ype C dislocations, the clavicle is displaced 2 cm or more from the ac
romion on plain anteroposterior radiographs and the attached origin of
the anterior deltoid is avulsed. Type C dislocations may benefit from
early operative reconstruction.