Razones para la cirugía precoz en las luxaciones acromioclaviculares tipo iii

There is growing interest to learn more about the complex scapulo-humeral biomechanics in order to apply them for a full and satisfactory recovery of our patients at discharge as well as for their future.

Applying the most appropriate treatment for acromioclavicular dislocations should be based on a clear standardisation when categorising the lesions, and associating a treatment option to each category. To considering this as solved question to date, seems arbitrary, since neither the imaging or clinical classification methods are well defined, and the surgical interventions are adequately compared to the non-surgical option in the literature.

There even appears to be a lack of data in the evaluation of outcomes. If it is considered that scapular dyskinesis puts our patients at risk of suffering a bad recovery after these dislocations, and that our main objective is getting the shoulder back to normal, it should be associated with trying to avoid this condition as far as possible. Thus, it should depend not only on good coordination and muscle training, but also on obtaining strong and stable articular structures that will support the heavy loads that the shoulder will have to bear.

In this review, it is suggested that early indication for surgery of acromioclavicular joint dislocations type iii, from an evidence based point of view, is not possible due to the numerous recommendations against surgery that have been published, and will probably be discussed in another chapter of this journal.

Therefore, this has been structured on a point of view based on reasonable doubts due to the arrival of new surgical techniques, new biomechanics studies on these techniques, and the growing interest in scapular dyskinesis and its importance in shoulder dysfunction.