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Konservativno zdravljenje akutne akromioklavikularne sindezmolize
Štefanič, Franc
Tossy classified AC joint injuries into three types. This system was modified by Rockwood into six types, which are presented in the article with recommendations for management of each type. ...Conservative treatment for types I and II and operative treatment for types IV, V and VI is generally accepted.In contrast, the management of type Ill AC dislocations is more controversial. However, during the past 70-75 years the trend toward nonoperative treatment has been documented. Surgical treatment is suggested only for younger patients, patients with jobs requiring heavy lifting and manual labour, athletes in noncontact sports and patients who find the deformity visually unacceptable. Some articles are quoted, which speak in favour for this trend. There are four basic operative techniques for the treatment of AC dislocations and each procedure has been modified in many ways. From January 7998 to December 2000 fifty-nine AC dislocations of type III were surgically treated at our clinical department for traumatology in Clinical centre in Ljubljana, ln this period 612 patients with AC joint injurywere examined. All AC dislocations type I and II and about half of dislocations type III were managed conservatively. Only in three cases after conservative treatment of type III late excision (>3 months after injury) of distal clavicle was necessary because of chronic pain with restricted shouldermotion. In six cases an operation was performed after 7-3 months afterinjury because of unsuccessful conservative therapy (four times coracoclavicular fixation with Bosworth screw and twice AC joint fixation wifhKirschner wires and wire loop).
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