Abstract
Although treatment of acute grade III acromioclavicular separation remains controversial, there has been a recent trend toward initial conservative treatment in most cases. We have performed conservative treatment of acute grade III acromioclavicular separations since 2001. If symptoms remain after conservative treatment, we perform surgery by a modified Dewar method. The present study was performed to review our therapeutic strategy.
Eight patients were treated conservatively with a sling for comfort through progressive early range of motion as tolerated. We investigated the clinical results with JSS (Japan Shoulder Society) AC joint score.
The results of conservative treatment were favorable in 6 of 8 patients, and the average JSS AC joint score was 95.2 points. Two patients underwent surgery by the modified Dewar method because of pain and easy fatigue. The JSS AC joint scores in the 2 patients that underwent surgery improved from 74 and 80 points to 98 and 100 points, respectively.
The use of a sling without reduction of the acromioclavicular joint, followed by a graduated exercise program led to acceptable clinical results. Treatment of patients with persistent pain of the acromioclavicular joint using the modified Dewar method resulted in improvement. These observations confirmed the efficacy of our therapeutic strategy for the treatment of acute grade III acromioclavicular separation.
