Moyal Andrew J, Burkhart Robert J, Adelstein Jeremy M, Voos James E, Apostolakos John M, Calcei Jacob G
Department of Orthopaedic Surgery, University Hospitals Drusinsky Sports Medicine Institute, Beachwood, OH, USA.
Case Western Reserve University School of Medicine, Cleveland, OH, USA.
Ann Jt. 2025 Jul 30;10:31. doi: 10.21037/aoj-25-19. eCollection 2025.
Acromioclavicular (AC) joint sprain and sternoclavicular (SC) joint injuries commonly occur in contact athletes due to the direct-blow mechanism of injury. Despite the high prevalence in this patient population, a small degree of literature on AC and SC joint injuries specifically pertain to contact athletes. The goal of this narrative review is to analyze the literature pertaining to AC and SC joint injuries in both contact athletes and the general population and to provide treatment recommendations specifically for the contact athlete.
A review of PubMed and MEDLINE was completed to identify articles reporting on the surgical and nonoperative treatment of AC and SC joint injuries in athletes. In this initial screen, the authors excluded general reviews, case reports, duplicate studies between databases and publications in languages other than English. The quality of included studies was assessed using the Methodological Index for Nonrandomized Studies (MINORS). The authors then conducted a search for studies comparing non-operative to operative treatment of AC and SC joint injuries, in addition to studies comparing between operative technique.
Non-operative management of AC and SC joint injuries offer an acceptable return-to-play timeline. Despite persistent pathologic radiographic appearance in certain cases of non-operative management, clinical outcomes are generally equivalent between athletes treated non-operatively as compared to operatively. In cases of a failed course of nonoperative treatment, surgical management can achieve high return-to-sport rates, though is generally associated with longer recovery intervals. Despite mechanism of injury, rate of successful return to previous level does not appear to correlate with degree of contact in a sport, but instead with overhead demand of the sport.
Contact athletes with AC and SC joint injuries should be trialed with a course of nonoperative management, even in higher grade injuries, with some exceptions. Athletes should be appropriately counseled, with particular attention paid to positions requiring increased overhead demand. When surgery is required, non-rigid anatomic fixation allows for a high rate of return to sport with less complications compared to rigid fixation.
肩锁关节（AC）扭伤和胸锁关节（SC）损伤在接触性运动运动员中较为常见，多因直接撞击机制导致受伤。尽管在这类患者群体中发病率较高，但专门针对接触性运动运动员的肩锁关节和胸锁关节损伤的文献较少。本叙述性综述的目的是分析有关接触性运动运动员和普通人群肩锁关节和胸锁关节损伤的文献，并针对接触性运动运动员提供具体的治疗建议。
完成对PubMed和MEDLINE的检索，以识别报道运动员肩锁关节和胸锁关节损伤手术及非手术治疗的文章。在初步筛选中，作者排除了一般性综述、病例报告、数据库间的重复研究以及非英语语言的出版物。使用非随机研究方法学指数（MINORS）评估纳入研究的质量。作者随后进行检索，以查找比较肩锁关节和胸锁关节损伤非手术与手术治疗的研究，以及比较手术技术的研究。
肩锁关节和胸锁关节损伤的非手术治疗提供了可接受的重返比赛时间线。尽管在某些非手术治疗病例中影像学表现持续存在病理改变，但与手术治疗的运动员相比，非手术治疗运动员的临床结果总体相当。在非手术治疗疗程失败的情况下，手术治疗可实现较高的重返运动率，不过通常恢复间隔较长。尽管损伤机制不同，但成功恢复到先前水平的比率似乎与运动中的接触程度无关，而是与运动的过头需求有关。
肩锁关节和胸锁关节损伤的接触性运动运动员，即使是较高级别的损伤，除某些例外情况外，均应先进行非手术治疗疗程。应给予运动员适当的咨询，尤其要关注对过头需求增加的位置。当需要手术时，与刚性固定相比，非刚性解剖固定可实现较高的重返运动率且并发症较少。
