The fate of the acromioclavicular joint in athletic injuries

Abstract

Of 164 acromioclavicular joint injuries to midshipmen at the US Naval Academy between July 1973 and November 1978, 99 were Type 1, 52 were Type 2, and 13 were Type 3. Follow-up examinations revealed that 36% of Type 1, 48% of Type 2, and 69% of Type 3 patients had residual symptoms. Positive physical findings were present in 43% of Type 1, 77% of Type 2, and 100% of Type 3 injuries. Roentgenographic changes were noted in 70% of Type 1, 75% of Type 2, and 100% of Type 3 patients.

This evaluation suggests aggressive treatment and rehabilitation are indicated in acute acromioclavicular injuries. Residual problems from Types 1 and 2 inju ries are much more frequent than indicated in the literature. Symptoms in Type 1, but not in Type 2, injuries are directly related to the presence of positive physical findings. Roentgenographic changes are ex tremely common and are not correlated with symp toms. Treatment of Type 2 injuries with the acromio clavicular immobilizer resulted in fewer complications than symptomatic treatment.

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References

Bergfeld JA, Andrish JT, Clancy WG Evaluation of the acromioclavicular joint following first and second degree sprains Am J Sports Med 6 153-158, 1978

Olix ML Editorial comment Am J Sports Med 6 158-159, 1978

Hoyt WA Jr Etiology of shoulder injuries in athletes J Bone Joint Surg 49A 755-766, 1967

Allman FL Fractures and ligamentous injuries of the clavicle and its articulation J Bone Joint Surg 49A 774-784, 1967

Urist MR Complete dislocations of the acromioclavicular joint The nature of the traumatic lesion with an analysis of forty-one cases J Bone Joint Surg 28 813-837, 1946

Unst MR Complete dislocations of the acromioclavicular joint J Bone Joint Surg 45A 1750-1753, 1963

Gurd FB The treatment of complete dislocation of the outer end of the clavicle An hitherto undescribed operation Ann Surg 113 1094-1098, 1941

Mumford EB Acromioclavicular dislocation A new operative treatment J Bone Joint Surg 23 799, 1941

Halaby, FA, Disalvo EI Osteolysis A complication of trauma Am J Roentgenol 94 591-594, 1965

10.

Jacobs P. Post-traumatic osteolysis of the outer end of the clavicle J Bone Joint Surg 46B 705-707, 1964

11.

Madsen B. Osteolysis of the acromial end of the clavicle following trauma Br J Radiol 36 822-828, 1963

12.

Werder H. Posttraumatische Usteolyse des Schlusselbeinendes Schweiz Med Wochenschr 80 912, 1950

13.

Norfray JF, Tremaine MJ, Groves HC, et al The clavicle in hockey Am J Sports Med 5 275-280, 1977

14.

Alexander OM Radiography of the acromioclavicular articulation Med Radiogr and Photogr 30 34-39, 1954

15.

Glick JM, Milburn LJ, Haggerty JF, et al Dislocation acromioclavicular joint. Follow-up study of 35 unreduced acromioclavicular dislocations Am J Sports Med 6 263-270, 1977