The surgical treatment of complete acromioclavicular joint dislocation.

Forty-eight patients with complete acromioclavicular (A-C) joint dislocation were treated surgically and followed postoperatively for an average of 26 months. Nineteen patients were treated with simple temporary pinning without ligament reconstruction. Eight of these patients were found, on follow-up x-ray, to have some degree of loss of reduction. All 21 patients treated with Neviaser's operation and all four patients treated with pinning and coracoclavicular (C-C) ligament reconstruction maintained their position on follow-up. One patient treated with arthrodesis of the C-C joint with a wire sustained metallic failure, and another treated with arthrodesis with a screw sustained bone erosion of the clavicle. Although the radiographic results were not necessarily good, 94% (45/48) of patients obtained good or excellent functional results. Reconstruction of either the superior A-C ligament or the C-C ligament, besides temporary fixation of the A-C joint, is recommended for surgical treatment of complete A-C joint dislocation.