Comparison of Surgical Treatment and Conservative Approach for Type III Acromioclavicular Dislocations

Objective: In this study, we aimed to compare the effectiveness and the results of surgical (modified Weaver-Dunn) and conservative treatment techniques for Rockwood type III acromioclavicular dislocation. Material and Methods: Thirty four patients with acromioclavicular dislocation were included in this study. The mean age was 43.6 +/- 10.2 years (range 21-60). Modified Weaver-Dunn technique was performed on 17 patients. The mean operation time after the trauma was 12 +/- 6.9 days (range 3-24 days). The remaining 17 patients were treated conservatively with an acromioclavicular bandage. The range of motion and strengthening of the shoulder muscles started during the sixth week of treatment in both groups. The mean follow up period of both groups was 32.8 +/- 12.1 months (range 12-72). Results: No complication occurred in either groups. According to Poigenfurst's criteria, the results were classified as good or excellent in both groups. No statistically significant difference was found between the results of the groups according to Poigenfurst's criteria (p> 0.05). Conclusion: Treatment modalities of type III acromioclavicular dislocation remain controversial. Satisfactory results have been reported when Modified Weaver-Dunn techniques were performed initially to young, active, laborer and athletes with acromioclavicular dislocation of the dominant extremity. In this study, we did not find a significant difference between surgical treatment and conservative approach in terms of measurements of functional outcomes. We concluded that the treatment of stage III dislocation can be modified according to the personal characteristics and the expectations of the patient. Current data indicates that both treatment modalities can be satisfactory.