OUTCOME OF RESULTS WITH CONSERVATIVE MANAGEMENT OF ROCKWOOD TYPE III ACROMIOCLAVICULAR DISLOCATION

BACKGROUND The acromioclavicular joint is commonly involved in traumatic injuries that affect the shoulder. Treatment of these injuries has been controversial and continues to evolve. According to literature, type I and II injuries are treated by conservative modalities and stage IV, V and VI injuries are advised to undergo surgery. There is no consensus regarding management of type III acromioclavicular dislocation. In this study, classification of acromioclavicular by TossyRockwood is followed. In type III acromioclavicular dislocation, a severe force is applied to the point of the shoulder, which tears the acromioclavicular and coracoclavicular ligaments resulting in a complete acromioclavicular dislocation. The distal clavicle appears to be displaced superiorly as the scapula and shoulder complex drop inferomedially. Radiographic findings include a 25100% increase in coracoclavicular space in comparison to normal side. The key to the diagnosis of type III injury is that the acromioclavicular joint can be reduced with upward pressure under the elbow or by having the patient actively shrug and reduce the joint. This is known as “shrug test.” A type III reducible injury is thus differentiated from type 4 or 5 injury, which cannot be reduced if the deltopectoral fascia is interposed.