Management of type 3 acromioclavicular joint dislocation: comparison of long-term functional results of two operative methods.

Introduction. Treatment of Rockwood Type 3 Acromioclavicular joint dislocation is controversial. We compared the long-term functional outcome of early repair of coracoclavicular ligament and internal fixation (Tension Band Wiring) with delayed reconstruction by modified Weaver-Dunn procedure for Type 3 dislocations. Method. Retrospective analysis of case records and telephone review to assess the long-term functional outcome by patient satisfaction and Oxford shoulder score. Results. We had 18 cases of Type 3 Acromioclavicular dislocations over a period of 10 years. 7 cases had Tension Band Wiring and 11 cases had modified Weaver-Dunn procedure. Early repair group has higher risk (71%) of post operative complications compared to that of the delayed reconstruction group (9%). All 5 patients who developed postoperative complications in the early repair group required a second operation for metal work removal. Long-term functional results of both groups were comparable in terms of Oxford shoulder score and patient satisfaction. Conclusions. We recommend modified Weaver-Dunn procedure for failed conservative management of Grade 3 Acromioclavicular joint dislocation for the following reasons (1). better short-term functional outcome, low risk of complications and hence faster recovery (2). no need for a second surgery.