Conservative therapy may be effective for treatment of type V AC dislocations
LAS VEGAS — Conservative treatment of type V acromioclavicular dislocations demonstrated successful outcomes in many patients, and average time before return to duty did not improve with immediate vs. delayed surgery, according to a presentation made during the American Academy of Orthopedic Surgeons Annual Meeting.
Researchers retrospectively reviewed the medical records of 41 patients with type V acromioclavicular (AC) dislocations, defined as a greater than 100% increase in the coracoclavicular (CC) distance compared with the contralateral side, or greater than 2 cm of displacement unilaterally of the clavicle’s superior border, from January 2007 to December 2012. Outcomes were compared for 10 patients who underwent acute acromioclavicular reconstruction (surgical intervention within 90 days of injury without a conservative therapy trial) and 22 patients for whom conservative therapy was recommended.
Of the 22 patients in the conservative therapy group, 11 returned to full duty without surgery at an average of 97.8 days, six underwent delayed surgery and returned to full duty after an average of 131.3 days and two revisions. Two of the patients in the conservative therapy group refused surgery and changed careers, and three were lost to follow-up.
Eight patients in the acute surgical group were able to return to full duty by an average 190.6 days postoperatively, with a mean time to surgery of 28.29 days. Among those eight patients, four required revision, one was lost to follow-up and one did not return to full duty, according to the researchers.
Among patients in the conservatively treated group who failed this method of treatment, the researchers observed a mean increase of 129% in CC distance and a mean displacement of 20.2 mm. Patients in the successfully treated group experienced an average increase of 105% in CC distance, as well as a mean displacement of 19.34 mm, according to the researchers. ‒ by Monica Jaramillo
Krul KP, et al. Paper #766. Presented at: American Academy of Orthopaedic Annual Meeting; March 24-28, 2015; Las Vegas.
Disclosure: The researchers report no relevant financial disclosures.