Manejo quirúrgico de la inestabilidad acromioclavicular aguda

Abstract

The surgical management of acute acromioclavicular instability is a common procedure within the pathology of the shoulder. In accordance with the Rockwood classification, an assessment should be made of the presence of a horizontal instability component besides the vertical instability. The treatment of acute acromioclavicular dislocations must be adapted to the demands of the patient. The low grade instabilities (types I and II) are treated conservatively. Those considered high grade (types IV-VI) should be treated surgically within 2-3 weeks from the injury. There is still debate on those of type III. The non-surgical treatment of type III injuries provides functional results at least similar to be able to start professional and sports activities. Among the surgical treatments used are found, open surgery procedures using Kirschner wires, polydioxanone pins, or other types of non-absorbable sutures, or hook plates. Arthroscopic techniques use new implants designed to align and reduce the coracoclavicular space. The advantage of arthroscopy is to be able to review and treat associated lesions in the glenohumeral in the same surgical operation.