Acromioclavicular joint injuries: a review of pathoanatomy, assessment and current management approaches

Q4 Medicine

Orthopaedics and Trauma Pub Date : 2023-10-01 DOI:10.1016/j.mporth.2023.07.004

Natasha Maher, Jessica Holdsworth, Simon J. Fogerty

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Abstract

Acromioclavicular joint (ACJ) injuries represent approximately 10% of all shoulder girdle injuries and their assessment and management can be clinically challenging. This may be for several reasons, including a lack of consensus concerning the reliability of the classification systems, contributing to suboptimal clinical outcomes. A paucity of literature regarding predictive factors for ACJ pathology may also be a factor. Controversy regarding conservative versus surgical management to provide optimal care also continues to be a factor in this clinical challenge, as similar results have been shown with both approaches. There is consensus that low-grade injuries can be treated with non-operative management, but some will go on to have long-term complications. However, the risks of surgical intervention may not out-weigh the benefits. In higher grade injuries there is further controversy over conservative versus surgical management. Improved classification systems and shared decision-making to individualize treatment plans are likely to improve patient outcomes. This review provides an overview of current assessment and management of ACJ injuries in adults.

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肩锁关节损伤:病理解剖，评估和目前的治疗方法的回顾

肩锁关节（ACJ）损伤约占所有肩带损伤的10%，其评估和管理可能具有临床挑战性。这可能是由于几个原因，包括对分类系统的可靠性缺乏共识，导致临床结果不理想。缺乏关于ACJ病理学预测因素的文献也可能是一个因素。关于保守治疗与手术治疗以提供最佳护理的争议仍然是这一临床挑战的一个因素，因为两种方法的结果相似。人们一致认为，低级别损伤可以通过非手术治疗，但有些损伤会出现长期并发症。然而，手术干预的风险可能并不超过收益。在更高级别的损伤中，保守治疗与手术治疗之间存在进一步的争议。改进分类系统和共享决策以个性化治疗计划可能会改善患者的预后。这篇综述概述了目前成人ACJ损伤的评估和管理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

1.00

自引率

0.00%

发文量

期刊介绍： Orthopaedics and Trauma presents a unique collection of International review articles summarizing the current state of knowledge and research in orthopaedics. Each issue focuses on a specific topic, discussed in depth in a mini-symposium; other articles cover the areas of basic science, medicine, children/adults, trauma, imaging and historical review. There is also an annotation, self-assessment questions and a second opinion section. In this way the entire postgraduate syllabus will be covered in a 4-year cycle.