Question:My 18-year old son separated his AC joint during a sporting event. I did the exact same thing 30 years ago when I was his age. I had surgery back then and returned to football the next season. His doctor just gave him a special sling and told him it would heal in time. Does this seem right?
Answer:Many things have changed over the past 30 years in the way acromioclavicular (AC) joint separations are treated. Surgery used to be the initial treatment for type III AC injuries.
With a type III separation, the AC ligaments are torn and the AC joint is dislocated. Surgery was designed to repair or reconstruct the ruptured soft tissues. This type of treatment is still used for some patients. But more surgeons prefer nonoperative care today.
With conservative care, the joint is held in place or immobilized with a sling to allow scar tissue to fill in and around the torn capsule. Past studies over the last 30 years haven't been able to show better results with surgery compared to using a sling.
There have been many changes in surgical technique and graft materials in the last 10 years. In the future, we may see the pendulum swing back toward the use of surgery as the preferred initial treatment for type III AC separations. For now immobilization followed by a rehab program seems to be favored by most surgeons.Carl W. Nissen, MD, and Abhishek Chatterjee, BA. Type III Acromioclavicular Separation: Results of a Recent Survey on Its Management. In American Journal of Orthopedics. February 2007. Vol. 36. No. 2. Pp. 89-93.
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