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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n\u003Cp id=\u0022p-1\u0022\u003ETreatment of acute grade III acromioclavicular joint dislocation with hook plate fixation or conservative management with a sling resulted in similar clinical outcomes at 12 months. Although most surgically treated acromioclavicular joints were reduced at 12 months, there were high complication and reoperation rates.\u003C\/p\u003E\n\u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Eacromioclavicular joint dislocation\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ehook plate fixation\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EConstant\u2013Murley score\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eorthopedics \u0026amp; sports medicine clinical trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eshoulder \u0026amp; elbow conditions\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eorthopedic conditions\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\n\n\u003Cp id=\u0022p-2\u0022\u003EHook plate fixation of acute grade III acromioclavicular (AC) joint dislocations resulted in similar clinical outcomes at 12 months compared with conservative therapy with a sling. St\u00e9phane Pelet, MD, PhD, FRCSC, H\u00f4pital Enfant-J\u00e9sus, Quebec, Quebec, Canada, presented data from a study comparing conservative treatment with surgical hook plate treatment [\u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT01110304\u0026amp;atom=%2Fspmdc%2F15%2F7%2F12.atom\u0022\u003ENCT01110304\u003C\/a\u003E].\u003C\/p\u003E\n\u003Cp id=\u0022p-3\u0022\u003EAC joint dislocation is a common injury and mainly results from an impact to the point of the shoulder. Conservative therapy with a sling is the predominant treatment, and the role for surgical therapy is still controversial. The purpose of this trial was to compare the efficacy of surgical treatment of acute grade III AC joint dislocation with a hook plate to the conservative management.\u003C\/p\u003E\n\u003Cp id=\u0022p-4\u0022\u003EIn this single-center, prospective trial, 56 patients with acute grade III AC dislocation were randomly assigned to undergo surgical treatment with hook plate fixation or conservative therapy with a sling. Patients were assessed at 1-year follow-up and then by telephone at 2 and 3 years. In patients who had undergone surgery, hardware removal was allowed at 6 months. Patient characteristics such as sex, smoking status, type of work (physical vs intellectual), and sporting level were similar among both arms.\u003C\/p\u003E\n\u003Cp id=\u0022p-5\u0022\u003EThe primary end point was Constant\u2013Murley score at 1 year. Secondary end points included Disabilities of the Arm, Shoulder, and Hand (DASH) score; shoulder range of motion; return to main activities; radiographic assessment; American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form; Rowe assessment score; and complications.\u003C\/p\u003E\n\u003Cp id=\u0022p-6\u0022\u003EAlthough patients in the surgical arm experienced significantly lower Constant\u2013Murley scores from 6 weeks to 6 months (\u003Cem\u003EP\u003C\/em\u003E\u2005\u0026lt;\u2005.01), by 12 months there was no significant difference compared with conservative therapy (\u003Cem\u003EP\u003C\/em\u003E\u2005=\u2005.61; \u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E). Similarly, the surgical group demonstrated higher DASH scores from 6 weeks to 6 months (\u003Cem\u003EP\u003C\/em\u003E\u2005\u0026lt;\u2005.01), but there was no significant difference at 12 months compared with conservative therapy (\u003Cem\u003EP\u003C\/em\u003E\u2005=\u2005.86).\u003C\/p\u003E\n\u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/7\/12\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Effect of Hook Plate Fixation on Outcomes in Acute Acromioclavicular Joint DislocationReproduced with permission from S Pelet, MD, PhD, FRCSC.\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-2034170507\u0022 data-figure-caption=\u0022Effect of Hook Plate Fixation on Outcomes in Acute Acromioclavicular Joint DislocationReproduced with permission from S Pelet, MD, PhD, FRCSC.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/7\/12\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/7\/12\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/7\/12\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/16260\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \u003Cp id=\u0022p-7\u0022 class=\u0022first-child\u0022\u003EEffect of Hook Plate Fixation on Outcomes in Acute Acromioclavicular Joint Dislocation\u003C\/p\u003E\n\u003Cp id=\u0022p-8\u0022\u003EReproduced with permission from S Pelet, MD, PhD, FRCSC.\u003C\/p\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n\u003Cp id=\u0022p-9\u0022\u003EAt 1 year, there was a significant difference in radiographic evaluation between the 2 arms (\u003Cem\u003EP\u003C\/em\u003E\u2005=\u2005.001). In the surgical arm, no joints remained dislocated, 3 were subluxated, and 23 were reduced. In the conservative-therapy arm, 30 joints were subluxated or dislocated. The coracoclavicular distance was significantly improved immediately after surgery for up to 12 months compared with the distance observed in patients who received conservative therapy (\u003Cem\u003EP\u003C\/em\u003E\u2005\u0026lt;\u2005.01).\u003C\/p\u003E\n\u003Cp id=\u0022p-10\u0022\u003EThere were no complications in the conservative-therapy group. In patients who underwent surgery, 9 complications occurred, including 8 acromial erosions and 1 plate failure. In addition, 92% of patients underwent reoperation for plate removal, whereas no patients in the conservative-therapy group underwent surgery (\u003Cem\u003EP\u003C\/em\u003E\u2005\u0026lt;\u2005.01). At 2- and 3-year follow-up, none of the patients had undergone further surgery for chronic AC joint pain or instability, and only 1 patient, who was treated with conservative therapy, reported slight pain but had full range of motion.\u003C\/p\u003E\n\u003Cp id=\u0022p-11\u0022\u003EProf Pelet concluded that the results from this study suggest that conservative management and surgical treatment of acute grade III AC dislocations result in similar outcomes by 12 months. Although safe, Prof Pelet pointed out that hook plate fixation was associated with high complication and reoperation rates. In addition, patients treated with conservative therapy appear satisfied with their care.\u003C\/p\u003E\n\u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2015 SAGE Publications\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/15\/7\/12.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzlpv1\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzlpv1\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}